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Case Report
Clinical investigation of Ramsay–Hunt syndrome with glossopharyngeal and vagal nerve involvement
1 Professor, Department of Health, Faculty of Health Sciences, Tsukuba University of Technology, Tsukuba, Ibaraki, Japan
2 Professor, Department of Neurology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
3 Professor, Department of Radiological Technology, Tsukuba International University, Ibaraki, Japan
Address correspondence to:
Nobuko Shiraiwa
4-12-7 Kasuga, Tsukuba, Ibaraki 305-8521,
Japan
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Article ID: 100019N06NS2024
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Shiraiwa N, Tamaoka A, Ohkoshi N. Clinical investigation of Ramsay–Hunt syndrome with glossopharyngeal and vagal nerve involvement. Edorium J Neurol 2024;9(1):5–8.ABSTRACT
Introduction: Ramsay–Hunt syndrome is a peripheral facial nerve palsy accompanied by an erythematous vesicular rash in the ear (zoster oticus). Although involvement of the facial and vestibulocochlear nerves is typical in Ramsay–Hunt syndrome, multiple cranial neuropathies are rare, and are often associated with poorer prognosis and systemic complications. Here, we evaluated the clinical course of a rare case of Ramsay–Hunt syndrome associated with glossopharyngeal and vagal nerve disorders.
Case Report: A 75-year-old man presented with right facial paralysis, hoarseness, and dysphagia, leading to the diagnosis of Ramsay–Hunt syndrome with glossopharyngeal and vagal nerve disorders. The time between onset and initiation of antiviral drug administration was six days. Five years earlier, the patient had developed deafness on the same side along with dizziness. Facial paralysis and dysphagia improved nine months after onset; however, deafness, dizziness, and hoarseness persisted. The possibility of vestibulocochlear nerve palsy due to Zoster sine herpete was therefore considered.
Conclusion: Ramsay–Hunt syndrome with multiple cranial neuropathies is rare and is usually associated with a poorer prognosis. In this case, facial paralysis and dysphagia improved nine months after onset;however, deafness, dizziness, and hoarseness persisted. Therefore, attention must be paid to unilateral cranial nerve disorders, including Zoster sine herpete, during the assessment process.
Keywords: Glossopharyngeal nerve, Herpes zoster, Ramsay–Hunt syndrome, Vagus nerve, Zoster sine herpete
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Acknowledgments
We would like to thank Editage (www.editage.jp) for English language editing.
Author ContributionsNobuko Shiraiwa - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Akira Tamaoka - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Norio Ohkoshi - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Nobuko Shiraiwa et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
