Ilyass Anouar, Naoufal Hjira
Received: 10 Dec 2019 - Accepted: 27 Apr 2020 - Published: 28 Apr 2020
Domain: Dermatology,Infectious disease,Otolaryngology (ENT)
Keywords: Ramsay-Hunt, herpes-zoster, facial paralysis
©Ilyass Anouar et al. PAMJ - Clinical Medicine (ISSN: 2707-2797). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Ilyass Anouar et al. Ramsay-Hunt syndrome. PAMJ - Clinical Medicine. 2020;2:166. [doi: 10.11604/pamj-cm.2020.2.166.21253]
Available online at: https://www.clinical-medicine.panafrican-med-journal.com/content/article/2/166/full
Ilyass Anouar1,&, Naoufal Hjira1
1Mohammed V University, Mohammed V Military Hospital, Dermatology Department, Rabat, Morocco
Ilyass Anouar, Mohammed V University, Mohammed V Military Hospital, Dermatology Department, Rabat, Morocco
A 27-year-old man consulting in the emergency room for an acute facial paralysis with deafness and vertigo for 4 days. Physical examination shows clustered vesicles in the external auditory canal without any oral involvement. Laboratory investigations and computed tomography imaging were unremarkable. Thus, we diagnosed herpes zoster octicus (RHS, type 2). Treatment consists in the combination of antiviral drugs (valaciclovir 3 g/day) and corticosteroids (methylprednisolone 80 mg/day) with topical antibiotics for crusty lesions of the ear. The patient was finally referred to the otorhinolaryngology department for the management of facial paresis. Ramsay Hunt syndrome (RHS) is a localized herpes zoster infection involving the seventh nerve and geniculate ganglia, resulting in hearing loss, vertigo, and facial nerve palsy and remains one of the major causes of atraumatic peripheral facial paralysis. Immunodeficiency states, particularly HIV infection, should be considered in younger patients, severe cases and patients with a history of specific risk behavior. In our patient, HIV serology was negative.
Figure 1: A) peripheral facial paralysis with deviation to the left (yellow arrow) and Bell´s phenomenon (red arrow); B) crusted vesicles in the ear (Ramsay-Hunt area) (red arrow)