Transaxonal Spread of Varicella-Zoster Virus in Trigeminal Zoster Followed by Ramsay Hunt Syndrome.

Neurol India

Department of Neurology, Shanghai General Hospital, Shanghai General Hospital (Originally Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, China.

Published: January 2022

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http://dx.doi.org/10.4103/0028-3886.333511DOI Listing

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Transaxonal Spread of Varicella-Zoster Virus in Trigeminal Zoster Followed by Ramsay Hunt Syndrome.

Neurol India

January 2022

Department of Neurology, Shanghai General Hospital, Shanghai General Hospital (Originally Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, China.

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Background: Ramsay Hunt Syndrome (RHS) is a neurotological disorder involving the reactivation of the varicella-zoster virus (VZV) in the geniculate ganglion of the facial nerve (Sweeney and Gilden in J Neurol Neurosurg Psychiatry 71:149-154, 2001). The characteristic presentation involves ipsilateral lower motor neuron type facial paresis, auricular pain with or without hearing impairment, and vesicular lesions of the external auditory canal and outer ear. Involvement of the facial and vestibulocochlear nerve is typical in RHS, whilst multiple cranial neuropathies are rare and associated with poorer prognosis and systemic complications (Arya et al.

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Objective: To study clinical/laboratory signs of primary vasculitis (PV) of the internal carotid artery (ICA) and vertebral artery (VA).

Material And Methods: We examined 31 patients (23 men, 74%, mean age - 36.2±5.

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Ramsay Hunt syndrome (RHS) occurs due to reactivation of latent Varicella Zoster Virus (VZV) infection in the geniculate ganglion of the facial nerve. Major clinical symptoms include ipsilateral facial paralysis, otic pain, and herpetic vesicles (rashes) along the nerve with accompanying ear pain. Rarely clinical findings include retrograde transaxonal spread of the virus from the ganglion into the brain parenchyma with developing the encephalitis or multiple cranial nerve involvement.

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We present a case of a 62-year-old Caucasian male with laryngeal cancer and Ramsay Hunt Syndrome otherwise known as herpes zoster oticus due to reactivation of the varicella zoster virus. Classic findings include the triad of ipsilateral facial paralysis, otic pain, and herpetic lesions in the sensory supply of the facial nerve. The common pathogenesis is associated with anterograde axonal reactivation of the varicella zoster virus in the geniculate ganglion.

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