Kuhweide R, Van de Steene V, Vlaminck S, Casselman J W
Department of Otorhinolaryngology-Head and Neck Surgery, AZ Sint-Jan Hospital, Brugge, Belgium.
J Laryngol Otol. 2002 Oct;116(10):844-8. doi: 10.1258/00222150260293691.
Ramsay Hunt's hypothesis that herpes zoster oticus results from reactivation of the varicella zoster virus (VZV) in the geniculate ganglion is supported by the detection of viral genome in archival temporal bones of normals and Ramsay Hunt patients by the polymerase chain reaction. Ramsay Hunt syndrome is characterized by the presence of cochleovestibular symptoms in association with facial paralysis. VZV has also been demonstrated in the spiral and/or vestibular ganglion. Two cases are reported in which cochleovestibular symptoms outweighed the facial nerve symptoms, presumably representing VZV reactivation in the spiral and/or vestibular ganglion. From these observations and the known dormancy of VZV in non-neuronal satellite cells, it is argued that the cochleovestibular symptoms in Ramsay Hunt syndrome may result from VZV transmission across the nerves inside the internal auditory canal and that prompt treatment with an antiviral-corticosteroid combination might be justified in the management of any acute non-hydropic cochleovestibular syndrome.
通过聚合酶链反应在正常人和拉姆齐·亨特综合征患者的颞骨存档标本中检测到病毒基因组，这支持了拉姆齐·亨特提出的耳带状疱疹是由膝状神经节中的水痘-带状疱疹病毒（VZV）再激活所致的假说。拉姆齐·亨特综合征的特征是伴有面神经麻痹的同时存在耳蜗前庭症状。在螺旋神经节和/或前庭神经节中也证实存在VZV。本文报告了两例耳蜗前庭症状比面神经症状更突出的病例，推测这代表了螺旋神经节和/或前庭神经节中的VZV再激活。基于这些观察结果以及VZV在非神经元卫星细胞中的已知潜伏情况，有人认为拉姆齐·亨特综合征中的耳蜗前庭症状可能是由于VZV通过内耳道内的神经传播所致，并且对于任何急性非积水性耳蜗前庭综合征的治疗，使用抗病毒药物与皮质类固醇联合进行及时治疗可能是合理的。
