Cytological and immunological examination of cerebrospinal fluid in 9 patients with Ramsay Hunt's syndrome.

The purpose of the present study was to carry out the immunological and cytological examination of cerebrospinal fluid in 9 patients with Ramsay Hunt's syndrome. The results obtained were as follows: Among the serum immunoglobulins, IgG in 1 and IgM in 5 of 9 cases increased. The Varicella Zoster antibody titer was significantly elevated in sera of all 9 cases and in CSF of all 7 examined cases. There ws positive fluorescence to Varicella Zoster virus in 2 (Cases 8 and 9) of 4 cases in which CSF smears were examined. The cells showing fluorescence were 10.5% in the former and 1.5% in the latter. Pleocytosis was found in all cases and CSF cell counts ranged from 52 to 2,000/3 mm3 in the early stage. In 3 cases immunoglobulin containing cells (IgG and IgM) were seen about 2-20% within 2 weeks of onset. IgG contents in all and IgG% in 8 of 9 cases, IgA concentration in 7 and IgA% in 7 of 9 cases were increased. These results support the view that the Varicella Zoster virus spreads to the meninges and CSF from ganglions in patients with Ramsay Hunt's syndromes.