Nishioka Kenya, Fujishima Kenji, Kobayashi Hirokazu, Mizuno Yoshikuni, Okuma Yasuyuki
Department of Neurology, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Inzunokuni, Shizuoka 410-2295, Japan.
Clin Neurol Neurosurg. 2006 Dec;108(8):772-4. doi: 10.1016/j.clineuro.2005.09.002. Epub 2005 Oct 13.
We report a patient with the varicella zoster viral (VZV) infection of multiple cranial nerves mimicking Garcin syndrome, who initially presented with Ramsay Hunt syndrome (herpes zoster oticus). A 78-year-old man showed left facial palsy with zosteric eruptions in his left auricle and dysphagia, followed by left total ophthalmoplegia. His serum anti-VZV antibody titer was elevated. Cerebrospinal fluid examination revealed pleocytosis with a slightly elevated protein level. He was treated with intravenous acyclovir and corticosteroids. His tongue weakness resolved, and then ocular movement improved. The improvement of facial palsy and swallowing difficulty was delayed. VZV infection should be considered even in patients who show unilateral multiple cranial neuropathy mimicking Garcin syndrome because it is treatable.
我们报告了一例表现为酷似加欣综合征的多组颅神经水痘带状疱疹病毒（VZV）感染患者，该患者最初表现为拉姆齐·亨特综合征（耳带状疱疹）。一名78岁男性出现左侧面瘫，左耳有带状疱疹皮疹及吞咽困难，随后出现左侧完全性眼肌麻痹。其血清抗VZV抗体滴度升高。脑脊液检查显示细胞数增多，蛋白水平略有升高。给予静脉注射阿昔洛韦和糖皮质激素治疗。其舌肌无力症状缓解，随后眼球运动改善。面瘫和吞咽困难的改善出现延迟。即使在表现为酷似加欣综合征的单侧多组颅神经病变患者中，也应考虑VZV感染，因为该病可治疗。
