Worme Mali, Chada Reena, Lavallee Lilia
3474 St, Famille, Apt 2, Montreal, Quebec H2X 2K8, Canada.
BMC Res Notes. 2013 Aug 28;6:337. doi: 10.1186/1756-0500-6-337.
Ramsay Hunt Syndrome (RHS) is a rare, severe complication of varicella zoster virus (VZV) reactivation in the geniculate ganglion. Facial paralysis is one of the features and without treatment, it fully recovers in as little as 20% of cases; this is much improved if treatment is started within 72 hours. This case is noteworthy in that coexistence of facial palsy with cervical dermatome involvement by VZV is not typical of RHS. Yet, it has been reported before.
A 54 year old Caucasian woman presented with right ear discomfort, difficulty hearing and a vesicular rash along the pinnae, 8 days after the eruption of a similar rash in the right C2-C4 dermatomes. 2 days later, she awoke with a partial right-sided facial paralysis, which improved with treatment (valacyclovir and prednisone).
This case is most pertinent to Family Practice, Otolaryngology and Neurology. It highlights the possible co-existence of RHS with cervical VZV reactivation and encourages physicians to monitor for this complication even before geniculate ganglion reactivation occurs. RHS is a rare disease that can present with vague symptoms. A high index of suspicion and close follow up are essential. Early intervention with antivirals and corticosteroids has shown significantly improved outcomes in these patients.
拉姆齐·亨特综合征（RHS）是膝状神经节中水痘带状疱疹病毒（VZV）再激活引起的一种罕见的严重并发症。面瘫是其特征之一，若不进行治疗，仅有20%的病例能完全康复；若在72小时内开始治疗，康复情况会有很大改善。该病例值得注意的是，面瘫与VZV累及颈皮节同时存在并非RHS的典型表现。不过，此前已有相关报道。
一名54岁的白人女性，在右侧C2 - C4皮节出现类似皮疹8天后，出现右耳不适、听力困难以及耳廓上的水疱性皮疹。2天后，她醒来时出现右侧部分面瘫，经治疗（伐昔洛韦和泼尼松）后有所改善。
该病例与家庭医学、耳鼻喉科和神经病学密切相关。它突出了RHS可能与颈部VZV再激活同时存在，并鼓励医生在膝状神经节再激活发生之前就监测这种并发症。RHS是一种可能表现出模糊症状的罕见疾病。高度的怀疑指数和密切随访至关重要。早期使用抗病毒药物和皮质类固醇进行干预已显示出能显著改善这些患者的预后。
