herpes zoster oticus


Summary: A syndrome characterized by facial palsy in association with a herpetic eruption of the external auditory meatus. This may occasionally be associated with tinnitus, vertigo, deafness, severe otalgia, and inflammation of the pinna. The condition is caused by reactivation of a latent HERPESVIRUS 3, HUMAN infection which causes inflammation of the facial and vestibular nerves, and may occasionally involve additional cranial nerves. (From Adams et al., Principles of Neurology, 6th ed, p757)

Top Publications

  1. Grose C, Bonthius D, Afifi A. Chickenpox and the geniculate ganglion: facial nerve palsy, Ramsay Hunt syndrome and acyclovir treatment. Pediatr Infect Dis J. 2002;21:615-7 pubmed
    ..Retrospective reviews suggest that patients with VZV-related facial nerve palsy have poorer outcomes than other cases of Bell's palsy. Therefore treatment with acyclovir is suggested when VZV reactivation i slikely...
  2. Nishioka K, Fujishima K, Kobayashi H, Mizuno Y, Okuma Y. An extremely unusual presentation of varicella zoster viral infection of cranial nerves mimicking Garcin syndrome. Clin Neurol Neurosurg. 2006;108:772-4 pubmed
    ..of multiple cranial nerves mimicking Garcin syndrome, who initially presented with Ramsay Hunt syndrome (herpes zoster oticus)...
  3. Lu Y, Young Y. Vertigo from herpes zoster oticus: superior or inferior vestibular nerve origin?. Laryngoscope. 2003;113:307-11 pubmed
    This study aims to analyze which division of vestibular nerve in the internal auditory canal is responsible for inducing vertigo in patients with herpes zoster oticus (HZO).
  4. Kinoshita T, Ishii K, Okitsu T, Okudera T, Ogawa T. Facial nerve palsy: evaluation by contrast-enhanced MR imaging. Clin Radiol. 2001;56:926-32 pubmed
    ..The purpose of this study was to investigate the value of contrast-enhanced magnetic resonance (MR) imaging in patients with peripheral facial nerve palsy...
  5. Ko J, Sheen T, Hsu M. Herpes zoster oticus treated with acyclovir and prednisolone: clinical manifestations and analysis of prognostic factors. Clin Otolaryngol Allied Sci. 2000;25:139-42 pubmed
    b>Herpes zoster oticus is a cranial polyneuropathy with facial nerve involvement as its main feature. The prognosis of the facial palsy is usually poor...
  6. Pereira F, Guskuma M, Luvizuto E, Faco E, Magro Filho O, Hochuli Vieira E. Unilateral facial paralysis caused by Ramsay Hunt syndrome. J Craniofac Surg. 2011;22:1961-3 pubmed publisher
    ..After 30 days after presentation, the patient did not show any signs or symptoms of the syndrome. At follow-up at 1 year, she showed no relapse of the syndrome...
  7. Segawa F, Kuroiwa Y. [Consideration on spreading mechanisms of cranial neuropathy in Ramsay Hunt syndrome: possibility of the vascular mechanism]. Rinsho Shinkeigaku. 2003;43:431 pubmed
  8. Nakatani H, Yamakawa K, Hamada M, Takeda T, Kakigi A, Iwai M. Initial lesions in Bell's palsy and Ramsay-Hunt syndrome. ORL J Otorhinolaryngol Relat Spec. 2010;71 Suppl 1:105-11 pubmed publisher
    ..The latencies of the preoperative responses corresponded to those recorded intraoperatively around the pyramidal segment of the facial nerve. ..
  9. Otsuki K, Kenmochi T, Maruyama M, Akutsu N, Iwashita C, Ito T, et al. A case of Ramsay Hunt syndrome in living-kidney transplant recipient. Transplant Proc. 2012;44:307-8 pubmed publisher
    ..This case demonstrated MRI to be a useful modality for the early diagnosis of Ramsay Hunt syndrome without vesicle eruption. ..

More Information


  1. Riemann R, Pfennigsdorf S, Riemann E, Naumann M. Successful treatment of crocodile tears by injection of botulinum toxin into the lacrimal gland: a case report. Ophthalmology. 1999;106:2322-4 pubmed
    ..After 6 months, hyperlacrimation reoccurred. No side effects were observed. Intraglandular injection of botulinum toxin into the lacrimal gland may serve as a sufficient therapy for crocodile tears. ..
  2. Mauprivez C, Comte C, Labrousse M, Khonsari R. Acute Facial Nerve Palsy With Ipsilateral Soft Palate Ulcers. J Oral Maxillofac Surg. 2017;75:1906-1914 pubmed publisher
    ..facial nerve palsy accompanied by ipsilateral ear pain and erythematous vesicular rash on the external ear (herpes zoster oticus) and in the mouth. Thus, diagnosis of RHS is usually clinical...
  3. Martínez Oviedo A, Lahoz Zamarro M, Uroz del Hoyo J. [Ramsay-Hunt syndrome]. An Med Interna. 2007;24:31-4 pubmed
    ..Compared with Bell s palsy, patients with zoster oticus often have more severe paralysis at onset and are less likely to recover completely. ..
  4. Balatsouras D, Rallis E, Homsioglou E, Fiska A, Korres S. Ramsay Hunt syndrome in a 3-month-old infant. Pediatr Dermatol. 2007;24:34-7 pubmed
    ..Infection with varicella zoster virus was proved by a significant increase in the serum anti-varicella zoster virus antibody titer during the convalescent phase of the disease. ..
  5. Mishriki Y. Ramsay Hunt syndrome revisited. Skinmed. 2004;3:130-1 pubmed
  6. Pazos Añón R, Machado Costa C, Farto E Abreu J. [Ramsay-Hunt syndrome complicated with cerebral venous thrombosis in an HIV-1-infected patient]. Enferm Infecc Microbiol Clin. 2007;25:69-70 pubmed
  7. Takemoto N, Horii A, Sakata Y, Inohara H. Prognostic factors of peripheral facial palsy: multivariate analysis followed by receiver operating characteristic and Kaplan-Meier analyses. Otol Neurotol. 2011;32:1031-6 pubmed publisher
    ..ENoG was the most effective factor for prediction of the prognosis of peripheral facial palsy, and more than 85% degeneration had the best specificity and sensitivity to predict nonrecovery. ..
  8. Andersen L, Christensen A, Thelle T. [Ramsay Hunt syndrome in a 13-year-old boy]. Ugeskr Laeger. 2013;175:507-8 pubmed
    ..A magnetic resonance imaging confirmed neuritis of the left facial nerve. The patient was treated with a combination of aciclovir and prednisolone for ten days. On follow-up one week later, full recovery had been obtained. ..
  9. Kodama Y, Okamoto Y, Nishi J, Hashiguchi S, Yamaki Y, Kurauchi K, et al. Ramsay Hunt syndrome in a girl with acute lymphoblastic leukemia during maintenance therapy. J Pediatr Hematol Oncol. 2013;35:e224-5 pubmed publisher
    ..Preemptive therapy with acyclovir before the development of vesicles should help the patient recover from facial palsy. ..
  10. Chodkiewicz H, Cohen P, Robinson F, Rae M. Ramsay Hunt syndrome revisited. Cutis. 2013;91:181-4 pubmed
    ..We report the case of a 30-year-old woman who developed Ramsay Hunt syndrome and also review the characteristic features of this disease. ..
  11. Mortada R, El Fakih R, Assi M. Unusual presentation of Ramsay Hunt syndrome in renal transplant patients: case report and literature review. Transpl Infect Dis. 2009;11:72-4 pubmed publisher
    ..We also review the literature on VZV infection in renal transplant patients. ..
  12. Diaz G, Rakita R, Koelle D. A case of Ramsay Hunt-like syndrome caused by herpes simplex virus type 2. Clin Infect Dis. 2005;40:1545-7 pubmed
    ..Clinical and laboratory-proven acyclovir resistance developed during therapy. Immunologic assays revealed normal reactivity to HSV-2. ..
  13. Da Silva H, Boullosa J, Arruda M. Secondary intermedius neuralgia-like pain in a young child. Cephalalgia. 2006;26:1483-4 pubmed
  14. Verm A, Scott I, Davis J. Necrotizing herpetic retinopathy associated with Ramsay Hunt syndrome. Arch Ophthalmol. 2002;120:989-90 pubmed
  15. Zehlicke T, Punke C, Haase K, Boltze C, Pau H. [Myxoma of the middle ear-a rare cause of facial palsy]. HNO. 2008;56:165-8 pubmed
    ..In any cases with clinically and radiologically unclear findings of the ear in connection with facial palsy, surgical exposure should be considered. ..
  16. Ortiz G, Koch S, Forteza A, Romano J. Ramsay hunt syndrome followed by multifocal vasculopathy and posterior circulation strokes. Neurology. 2008;70:1049-51 pubmed publisher
  17. Ozel L, Toros S, Unal E, Kara M, Eren P, Canbakan M, et al. Ramsay Hunt syndrome with atypical progress in a renal transplant recipient: a case report. Exp Clin Transplant. 2011;9:413-6 pubmed
    ..Management and differential diagnosis of this particular case are discussed with a review of the literature. ..
  18. Gacek R. The biology of neurotropic viruses. Adv Otorhinolaryngol. 2002;60:1-11 pubmed
  19. Yeong S, Tassone P. Acute unilateral facial nerve palsy. Aust Fam Physician. 2011;40:296-8 pubmed
    ..Examination revealed yellow crusts and small vesicles on the external acoustic meatus (Figure 2). A 10 mm well defined firm and nontender nodule was palpable at the ramus of the mandible. ..
  20. Demir U, Basut O. [Ramsay Hunt syndrome and current approaches]. Kulak Burun Bogaz Ihtis Derg. 2012;22:59-63 pubmed publisher
    ..However, there is a limited number of studies which proved the efficacy of this treatment. ..
  21. Sené T, Gesquière Dando A, Riou B. [Trigeminofacial zoster]. Rev Prat. 2008;58:1407 pubmed
  22. Kaberos A, Balatsouras D, Korres S, Kandiloros D, Economou C. Audiological assessment in Ramsay Hunt syndrome. Ann Otol Rhinol Laryngol. 2002;111:68-76 pubmed
    ..In all of the performed tests, abnormalities were present only on the affected side. The audiological data suggested cochlear or retrocochlear involvement or involvement at more than one site along the auditory pathway. ..
  23. Nakamura Y, Matsumoto H. [Case of atypical Ramsay-Hunt syndrome who presented with severe vertigo and vomiting]. No To Hattatsu. 2012;44:66-8 pubmed
    ..She presented with an earache, severe vertigo, and vomiting at onset, and thereafter, herpes zoster oticus appeared. No facial nerve palsy was seen...
  24. Furuta Y, Ohtani F, Fukuda S, Inuyama Y, Nagashima K. Reactivation of varicella-zoster virus in delayed facial palsy after dental treatment and oro-facial surgery. J Med Virol. 2000;62:42-5 pubmed
    ..The results suggest that VZV reactivation is a major cause of delayed facial palsy after dental treatment or oro-facial surgery. ..
  25. Ozer F, Duransoy Y, Camlar M. Atypic geniculate neuralgia: atypic anatomic correlation of cranial nerve roots and AICA. Acta Neurochir (Wien). 2009;151:1003-4; discussion 1004 pubmed publisher
    ..At operation the anterior inferior cerebellar artery was coursing with the nerves and was separated. After the decompression the pain resolved immediately. ..
  26. Oge A, Yayla V, Demir G, Eraksoy M. Excitability of facial nucleus and related brain-stem reflexes in hemifacial spasm, post-facial palsy synkinesis and facial myokymia. Clin Neurophysiol. 2005;116:1542-54 pubmed
    ..To compare the electrophysiological excitability characteristics of the facial nucleus and related structures in hemifacial spasm (HFS), post-facial palsy synkinesis (PFPS) and facial myokymia (FM)...
  27. Wagner G, Klinge H, Sachse M. Ramsay Hunt syndrome. J Dtsch Dermatol Ges. 2012;10:238-44 pubmed publisher
    Ramsay Hunt syndrome is defined as herpes zoster oticus associated with an acute peripheral facial nerve paresis and quite often with other cranial nerve lesions...
  28. Mikula I. [Craniofacial neuralgias]. Acta Med Croatica. 2008;62:163-72 pubmed
    ..Neurologic and neuroradiologic examination is advised in all cases to rule out diseases such as intracranical tumors, vascular malformations or multiple sclerosis. ..
  29. Babtain F, Bhatia H, Assiri A. Ramsay Hunt syndrome with multiple cranial neuropathies in a liver transplant recipient. Neurosciences (Riyadh). 2012;17:262-4 pubmed
    ..Varicella zoster virus should be considered as a cause of multiple cranial neuropathies in an immune compromised patient, and abrupt treatment with acyclovir should be initiated once this diagnosis is suspected. ..
  30. Tabery H. Corneal epithelial keratitis in herpes zoster ophthalmicus: "delayed" and "sine herpete". A non-contact photomicrographic in vivo study in the human cornea. Eur J Ophthalmol. 2002;12:267-75 pubmed
    ..To investigate the origin of corneal epithelial keratitis occurring without accompanying herpes zoster ophthalmicus (HZO) cutaneous rash...
  31. Louis E, Williams M. A biography of James Ramsay Hunt (1874-1937). J Hist Neurosci. 2003;12:266-75 pubmed
  32. Gross G, Schöfer H, Wassilew S, Friese K, Timm A, Guthoff R, et al. Herpes zoster guideline of the German Dermatology Society (DDG). J Clin Virol. 2003;26:277-89; discussion 291-3 pubmed
    ..Thus early presentation to a pain therapist is recommended in specific cases...
  33. Nakatani H, Iwai M, Hamada M, Yamakawa K, Kakigi A, Takeda T. Early assessment of nerve degeneration using the antidromic facial nerve response. ORL J Otorhinolaryngol Relat Spec. 2010;71 Suppl 1:99-104 pubmed publisher
    ..The mean value of the N/T ratio in patients with a poor outcome fell to <0.4 after the 3rd day from onset, while that in patients with a good outcome was stable between 0.4 and 0.6 during the first week. ..
  34. Miyazaki Y, Tajima Y, Sudo K, Matsumoto A, Kikuchi S, Tashiro K. [A case of Ramsay Hunt syndrome initiated with hoarseness and dysphagia: consideration on spreading mechanisms of cranial neuropathy]. Rinsho Shinkeigaku. 2002;42:855-8 pubmed
    ..Additionally, spreading mechanisms of cranial neuropathy, and the early diagnostic problems of these conditions were discussed. ..
  35. Nakagawa H, Nagasao M, Kusuyama T, Fukuda H, Ogawa K. A case of glossopharyngeal zoster diagnosed by detecting viral specific antigen in the pharyngeal mucous membrane. J Laryngol Otol. 2007;121:163-5 pubmed
    ..His throat pain and dysgeusia completely resolved. We discuss the advantages of direct immunofluorescence staining for varicella zoster virus antigen for the diagnosis of glossopharyngeal zoster...
  36. Wada S, Haginomori S, Mori A, Ichihara T, Kanazawa A, Kawata R, et al. The midline electroneurography method for facial palsy reflects total nerve degeneration. Acta Otolaryngol. 2013;133:327-33 pubmed publisher
    ..The midline electroneurography (ENoG) method might reflect total facial nerve degeneration...
  37. Ohtani F, Furuta Y, Aizawa H, Fukuda S. Varicella-zoster virus load and cochleovestibular symptoms in Ramsay Hunt syndrome. Ann Otol Rhinol Laryngol. 2006;115:233-8 pubmed
    ..The present study analyzed the relationship between VZV load and the onset of CVSs in RHS...
  38. Antic B, Peric P, Ivanovic S, Spaić M. [Neuralgias of the lower cranial nerves: microsurgical posterior fossa exploration]. Acta Chir Iugosl. 2004;51:39-43 pubmed
    ..Microsurgical posterior fossa exploration is the method of choice in the treatment of the neuralgias of the lower cranial nerves...
  39. Donati D, De Santi L, Ginanneschi F, Cerase A, Annunziata P. Successful response of non-recovering Ramsay Hunt syndrome to intravenous high dose methylprednisolone. J Neurol Sci. 2012;318:160-2 pubmed publisher
  40. Gevers G, Lemkens P. Bilateral simultaneous facial paralysis--differential diagnosis and treatment options. A case report and review of literature. Acta Otorhinolaryngol Belg. 2003;57:139-46 pubmed
    ..In this article, we review the differential diagnoses and treatment options of bilateral facial paresis and present a scheme that is helpful in the diagnostic evaluation of this condition...
  41. Arbusow V, Theil D, Strupp M, Mascolo A, Brandt T. HSV-1 not only in human vestibular ganglia but also in the vestibular labyrinth. Audiol Neurootol. 2001;6:259-62 pubmed
    ..2) As benign paroxysmal positional vertigo often occurs in patients who have had VN, it could also be a sequel of viral labyrinthitis...
  42. Kim J, Chung P, Oh S, Hong S, Chung C, Jung C, et al. Ramsay Hunt syndrome complicated by a brainstem lesion. J Clin Virol. 2007;39:322-5 pubmed
  43. Naganawa S, Sugiura M, Kawamura M, Fukatsu H, Nakashima T, Maruyama K. Prompt contrast enhancement of cerebrospinal fluid space in the fundus of the internal auditory canal: observations in patients with meningeal diseases on 3D-FLAIR images at 3 Tesla. Magn Reson Med Sci. 2006;5:151-5 pubmed
    ..Enhancement in the IAC fundus was frequently observed in patients with meningeal disease, even just 10 min after administration of contrast agent. This enhancement in the IAC fundus was never visible on T1-weighted 3D-FLASH images...
  44. Jan A, McGuire T, Clokie C, Sandor G. Unilateral facial swelling caused by Ramsay Hunt syndrome resembles odontogenic infection. J Can Dent Assoc. 2006;72:829-32 pubmed
    ..It is intended to familiarize dentists with the Ramsay Hunt syndrome and the need for prompt recognition and early definitive treatment...
  45. Xanthopoulos J, Noussios G, Papaioannides D, Exarchakos G, Assimakopoulos D. Ramsay Hunt syndrome presenting as a cranial polyneuropathy. Acta Otorhinolaryngol Belg. 2002;56:319-23 pubmed
    ..Early institution of treatment with antiviral agents may help hasten healing. Involvement of the XIIth cranial nerve has not been reported previously...
  46. Tubbs R, Steck D, Mortazavi M, Cohen Gadol A. The nervus intermedius: a review of its anatomy, function, pathology, and role in neurosurgery. World Neurosurg. 2013;79:763-7 pubmed publisher
    ..Therefore, the present study aimed to further elucidate the diagnosis of this pain syndrome and its surgical treatment based on a review of the literature...
  47. Linder T, Abdelkafy W, Cavero Vanek S. The management of peripheral facial nerve palsy: "paresis" versus "paralysis" and sources of ambiguity in study designs. Otol Neurotol. 2010;31:319-27 pubmed publisher
    Conservative management of idiopathic or herpetic acute peripheral facial palsy (herpes zoster oticus, HZO) often leads to a favorable outcome. However, recent multicenter studies have challenged the necessity of antivirals...
  48. Furuta Y, Ohtani F, Sawa H, Fukuda S, Inuyama Y. Quantitation of varicella-zoster virus DNA in patients with Ramsay Hunt syndrome and zoster sine herpete. J Clin Microbiol. 2001;39:2856-9 pubmed
    ..The VZV load does not appear to reflect a major difference between RHS and ZSH...
  49. Kim I, Shin S, Kim J, Lee W, Lee H. Correlation between MRI and operative findings in Bell's palsy and Ramsay Hunt syndrome. Yonsei Med J. 2007;48:963-8 pubmed
    ..To investigate the correlation between gadolinium enhanced magnetic resonance image (MRI) results and surgical findings of facial nerves in Bell's palsy and Ramsay Hunt syndrome...
  50. Koga C, Iwamoto O, Aoki M, Nakamura C, Kusukawa J, Matsuishi T. Ramsay-Hunt syndrome with vesicular stomatitis in a 4-year-old infant. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102:e37-9 pubmed
    ..She was treated with acyclovir and steroids. Six months later, her facial paralysis had almost fully resolved...
  51. Pino Rivero V, Gonzalez Palomino A, Trinidad Ramos G, Pantoja Hernandez C, Marcos Garcia M, Keituqwa Yáñez T, et al. [Bogorad syndrome or crocodile tears after Ramsay-Hunt]. An Otorrinolaringol Ibero Am. 2006;33:225-9 pubmed
    ..We report the case of a 50 years old female with that pathology associated to facial syncinesias secondary to suffer a right Ramsay-Hunt syndrome. Its pathogenesis and different treatment modalities are analysed...
  52. Coleman C, Fozo M, Rubin A. Ramsay Hunt syndrome with severe dysphagia. J Voice. 2012;26:e27-8 pubmed publisher
    ..Pharyngeal wall and vocal fold paralysis, and severely reduced laryngeal elevation, resulted in such significant dysphagia that percutaneous endoscopic gastrostomy tube placement was required...
  53. Furuta Y. [Ramsay Hunt syndrome]. Nihon Rinsho. 2006;64 Suppl 3:281-4 pubmed
  54. Morishima N, Yagi R, Shimizu K, Ota S. Prognostic factors of synkinesis after Bell's palsy and Ramsay Hunt syndrome. Auris Nasus Larynx. 2013;40:431-4 pubmed publisher
    ..This study evaluated the prognostic factors of synkinesis following Bell's palsy and Ramsay Hunt syndrome...
  55. Furuta Y, Aizawa H, Ohtani F, Sawa H, Fukuda S. Varicella-zoster virus DNA level and facial paralysis in Ramsay Hunt syndrome. Ann Otol Rhinol Laryngol. 2004;113:700-5 pubmed
    ..It seems that the VZV DNA level in saliva reflects the kinetics of viral reactivation in the facial nerve, as well as in the oropharyngeal epithelium, in patients with Ramsay Hunt syndrome...
  56. Ali F, Rowley M, Jayakrishnan B, Teuber S, Gershwin M, Mackay I. Stiff-person syndrome (SPS) and anti-GAD-related CNS degenerations: protean additions to the autoimmune central neuropathies. J Autoimmun. 2011;37:79-87 pubmed publisher
    ..Closer study of the mysterious stiff-person syndrome should enhance the understanding of this disease itself, and autoimmunity in general...
  57. Gómez Torres A, Medinilla Vallejo A, Abrante Jiménez A, Esteban Ortega F. [Ramsay-Hunt syndrome presenting laryngeal paralysis]. Acta Otorrinolaringol Esp. 2013;64:72-4 pubmed publisher
    ..It may be associated with deafness, tinnitus and dizziness. It can sometimes affect the lower cranial nerves. A case of an immunocompetent patient with affectation of the VII, VIII and X cranial nerves is presented...
  58. Akyol A, Kiylioglu N, Copcu E. An unusual cause of trismus: Ramsay Hunt syndrome. J Plast Reconstr Aesthet Surg. 2006;59:206-7 pubmed
  59. Gilden D, Cohrs R, Mahalingam R, Nagel M. Neurological disease produced by varicella zoster virus reactivation without rash. Curr Top Microbiol Immunol. 2010;342:243-53 pubmed publisher
    ..Virological confirmation requires the demonstration of amplifiable VZV DNA in cerebrospinal fluid (CSF) or in blood mononuclear cells, or the presence of anti-VZV IgG antibody in CSF or of anti-VZV IgM antibody in CSF or serum...
  60. Alicandri Ciufelli M, Aggazzotti Cavazza E, Genovese E, Monzani D, Presutti L. Herpes zoster oticus: a clinical model for a transynaptic, reflex pathways, viral transmission hypotheses. Neurosci Res. 2012;74:7-9 pubmed publisher
    ..VZV) along the sensory nerves innervating the ear, including the geniculate ganglion, is responsible for herpes zoster oticus (HZO)...
  61. Nogueira R, Seeley W. Ramsay Hunt syndrome associated with spinal trigeminal nucleus and tract involvement on MRI. Neurology. 2003;61:1306-7 pubmed
  62. Fang C, Lin C. Ramsay Hunt syndrome with hemiparesis and hemihypoesthesia: report of 2 cases. Acta Neurol Taiwan. 2009;18:276-80 pubmed
    ..Magnetic resonance imaging of the brain in both cases showed no abnormality. The manifestations were compared with two more cases from the literature...
  63. Kim Y, Chang M, Jung H, Park Y, Lee S, Lee J, et al. Prognosis of Ramsay Hunt syndrome presenting as cranial polyneuropathy. Laryngoscope. 2010;120:2270-6 pubmed publisher
    ..Ramsay Hunt syndrome is known to be accompanied with cranial polyneuropathy very occasionally. We reviewed our experience to analyze the clinical manifestations and prognosis of these cases...
  64. Kui R, Bata Csorgo Z, Zeher M, Kemeny L. [Ramsay Hunt syndrome]. Orv Hetil. 2012;153:1281-3 pubmed publisher
    ..The authors emphasize the importance of early diagnosis and adequate combination therapy, which improves the prognosis of this disease...
  65. Iwasaki H, Toda N, Takahashi M, Azuma T, Nakamura K, Takao S, et al. Vestibular and cochlear neuritis in patients with Ramsay Hunt syndrome: a Gd-enhanced MRI study. Acta Otolaryngol. 2013;133:373-7 pubmed publisher
    ..Refractory hearing loss in patients with Ramsay Hunt syndrome may be due to cochlear neuritis following the spread of VZV...
  66. Magliulo G, D Amico R, Celebrini A, Cuiuli G. Postoperative Ramsay-Hunt syndrome after acoustic neuroma resection. Viral reactivation. An Otorrinolaringol Ibero Am. 2005;32:253-9 pubmed
    ..Theoretically, the prophylactic antiviral therapy might prevent the evolution towards the herpes zoster oticus or reduce the severity of the symptoms allowing the preservation of the hearing function...
  67. Van de Steene V, Kuhweide R, Vlaminck S, Casselman J. Varicella zoster virus: beyond facial paralysis. Acta Otorhinolaryngol Belg. 2004;58:61-6 pubmed
    J. Ramsay Hunt's hypothesis that herpes zoster oticus results from a reactivation of the herpes zoster virus in the geniculate ganglion, has been supported by the demonstration of varicella zoster viral DNA in the geniculate ganglion of ..
  68. Saito S, Ochi K, Kobayashi T, Sugiura N, Komatsuzaki Y, Ohashi T. Vestibular-evoked myogenic potentials in two patients with Ramsay Hunt syndrome. Auris Nasus Larynx. 2003;30 Suppl:S89-92 pubmed
    ..e., 105 db nhl)...
  69. Byun H, Cho Y, Jang J, Chung K, Hwang S, Chung W, et al. Value of electroneurography as a prognostic indicator for recovery in acute severe inflammatory facial paralysis: a prospective study of Bell's palsy and Ramsay Hunt syndrome. Laryngoscope. 2013;123:2526-32 pubmed publisher
    ..To evaluate the prognostic and predictive value of electroneuronography (ENoG) in acute severe inflammatory facial paralysis, including Bell's palsy and Ramsay Hunt syndrome (RHS)...
  70. Paiva A, Araújo J, Ferraz V, Veiga J. Facial paralysis due to Ramsay Hunt syndrome - A rare condition. Rev Assoc Med Bras (1992). 2017;63:301-302 pubmed publisher
    Ramsay Hunt syndrome (or herpes zoster oticus) is a rare complication of herpes zoster in which reactivation of latent varicella zoster virus infection in the geniculate ganglion occurs...
  71. Murakami S, Nakashiro Y, Mizobuchi M, Hato N, Honda N, Gyo K. Varicella-zoster virus distribution in Ramsay Hunt syndrome revealed by polymerase chain reaction. Acta Otolaryngol. 1998;118:145-9 pubmed
    ..The present study will facilitate better understanding of the pathogenesis of facial nerve paralysis, vertigo, hearing impairment and other cranial nerve dysfunction of Ramsay Hunt syndrome...
  72. Fota Markowska H, Rolla Szczepańska R, Modrzewska R, Kiciak S. [Ramsay Hunt syndrome--a case study]. Wiad Lek. 2003;56:375-7 pubmed
    ..The combined treatment with antiviral drugs and corticosteroids was partially successful and did not resolve the seventh nerve palsy...
  73. Walther L, Prosowsky K, Walther A, Gudziol H. [Herpes zoster oticus: symptom constellation and serological diagnosis]. Laryngorhinootologie. 2004;83:355-62 pubmed
    b>Herpes zoster oticus is a rare illness with cutaneous symptoms (eruptions) and a colored picture of brain nerve failures...
  74. Aoyagi M. [Accuracy of the prognostic diagnosis in acute peripheral facial palsy]. Nihon Jibiinkoka Gakkai Kaiho. 2005;108:1-7 pubmed
    ..An antidromic facial nerve response probably contributes to a precise prediction of prognosis within 3 days after the onset of facial palsy...
  75. Bhagra A, Stead L. Images in emergency medicine. Ramsay Hunt syndrome: a rare entity. Ann Emerg Med. 2006;47:579, 584 pubmed
  76. Wassilew S. [Varicella-zoster virus infections. 1: Chickenpox and shingles. Treatment and prevention]. MMW Fortschr Med. 2006;Spec no.1:1-5; quiz 6 pubmed
  77. Koudounarakis E, Balamatsis Z, Xenaki E, Kyrmizakis D. Herpes zoster laryngitis and Ramsay-Hunt syndrome in a patient with chronic renal failure. B-ENT. 2011;7:293-5 pubmed
    ..We report on a clinical case of simultaneous and unilateral involvement of the facial and superior laryngeal nerve in a patient with chronic renal disease undergoing haemodialysis...
  78. Hyden D, Roberg M. [Diagnosis of Ramsey Hunt syndrome is both simple and difficult. The viral attack is more extensive than expected earlier]. Lakartidningen. 2000;97:1114-20 pubmed
    ..of the head and neck in combination with facial palsy), the vesicles often appear on the external ear (herpes zoster oticus) but they can also be found on the exterior of the neck...
  79. Tang J, Geng M. [Clinical analysis of 32 cases of Ramsay Hunt syndrome]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013;27:485-7 pubmed
    ..To observe the clinical features and the treatment effect of 32 cases of Ramsay Hunt syndrome and explore the relationship between different clinical manifestations and the prognosis...
  80. Nowak D, Linder S, Topka H. Diagnostic relevance of transcranial magnetic and electric stimulation of the facial nerve in the management of facial palsy. Clin Neurophysiol. 2005;116:2051-7 pubmed
  81. Kim J, Chung S, Moon I, Lee H, Lee W. Correlation between enhanced MRI and surgical findings in herpes zoster oticus. Acta Otolaryngol. 2009;129:900-5 pubmed publisher
    ..This study demonstrates good correlation between enhanced MRI and surgical findings...
  82. Furuta Y, Oridate N, Takeichi N, Fukuda S, Sawa H. Alpha-defensin overexpression in patients with Bell's palsy and Ramsay Hunt syndrome. Ann Otol Rhinol Laryngol. 2012;121:419-25 pubmed
  83. T Selasic H, Zenebe G. Ramsay Hunt syndrome. Ethiop Med J. 2006;44:401-4 pubmed
    ..The objective of this case report is to address herpes zoster & its complications with the treatment modalities & an uncommon clinical entity, Ramsay hunt syndrome...
  84. Gupta J, Hutchins T, Palacios E. Ramsay Hunt syndrome, type I. Ear Nose Throat J. 2007;86:138, 140 pubmed
  85. Kim D, Bhimani M. Ramsay Hunt syndrome presenting as simple otitis externa. CJEM. 2008;10:247-50 pubmed
    ..She presented to the ED again after 2 days and was correctly diagnosed with Ramsay Hunt syndrome. We describe the clinical presentation, diagnostic findings and management of this uncommon but important entity...
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    ..The authors' results affirm the efficacy and broaden the application of motor cortex stimulation to several forms of intractable facial pain...
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    ..Ramsay Hunt syndrome (RHS) is a disease caused by the Varicella Zoster virus and characterised by skin rash, peripheral facial palsy and otologic symptoms...
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    To determine if an accurate prognosis can be made in patients with Herpes zoster oticus (HZO), facial nerve outcomes were assessed at 1-year after onset and compared with symptoms and signs at presentation.
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