Abstract
Ramsay Hunt syndrome (RHS) is a disease that is caused by the varicella-zoster virus and is characterized by severe ear pain, auricular vesicular eruptions, and peripheral facial paralysis.
Objective: The aim of this case report is to provide information about the clinical findings and treatment process of RHS, which is a rare case and may have oral findings and stress the importance of early diagnosis.
Case Report: A 60-year-old male patient had previously consulted an otolaryngologist and a family physician with complaints of vesicular eruptions in the right ear auricle and on the mandible. The patient in whom a diagnosis could not be established presented to the Department of Oral and Maxillofacial Radiology after exacerbated lesions. White plaque-like and ruptured vesicular lesions were observed in the intraoral examination. All vesicular lesions were on one side of the face, and the patient was referred to the dermatology clinic with the diagnosis of RHS. Facial paralysis fully recovered in a short time after early diagnosis and treatment. It should be kept in mind that there may also be oral findings in RHS, and a patient’s intraoral and extraoral examination findings should be evaluated together.
Conclusion: Early diagnosis and treatment are highly important in preventing complications such as permanent facial paralysis, vestibulocochlear dysfunction, and hearing loss
References
- Hunt JR. On herpetic inf lammations of the geniculate ganglion. A new syndrome and its complications. J Nerv Ment Dis. 1907; 34(2):73-96.
- Ostwal S, Salins N, Deodhar J, Muckaden MA. Management of ramsay hunt syndrome in an acute palliative care setting. Indian J Palliat Care. 2015; 21(1):79-81.
- Sommer T, Karsy M, Driscoll MJ, Jensen RL. Varicella-Zoster virus infection and osteomyelitis of the skull. World Neurosurg. 2018; 115:297-300.
- Coulson S, Croxson GR, Adams R, Oey V. Prognostic factors in herpes zoster oticus (ramsay hunt syndrome). Otol Neurotol. 2011; 32(6):1025- 30.
- Cai Z, Li H, Wang X, Niu X, Ni P, Zhang W, Shao B. Prognostic factors of Bell’s palsy and Ramsay Hunt syndrome. Medicine (Baltimore). 2017; 96(2):e5898.
- Mercier T, Deslypere G, Nackaerts K. Ramsay Hunt syndrome: A rare complication of herpes zoster infection in a lung cancer patient. Acta Clin Belg. 2019; 74(5):355-8.
- Rasmussen ER, Lykke E, Toft JG, Mey K. Ramsay Hunt syndrome revisited–emphasis on Ramsay Hunt syndrome with multiple cranial nerve involvement. Virol Discov. 2014; 2(1):1-7.
- Meydan Ocak FD, Tutar İ, Yıldırım A, Konuralp N, Aydoğan AR, Arslan BN, Özgüzel MH. Case report: Ramsay-Hunt Syndrome, peripheral facial paralysis treated with electrostimulation. Turk J Phys Med Rehabil. 2005; 51(3):111-3.
- Patel DK, Levin KH. Bell palsy: Clinical examination and management. Cleve Clin J Med. 2015; 82(7):419-26.
- Günhan Ö. Oral ve Maksillofasiyal Patoloji [Oral and Maxillofacial Pathology]. 1st Ed. Istanbul: Quintessence; 2015.
- House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985; 93(2):146-7.
- Sobn AJ, Tranmer PA. Ramsay Hunt syndrome in a patient with human immunodeficiency virus infection. J Am Board Fam Pract. 2001; 14(5):392-4.
- Wagner G, Klinge H, Sachse MM. Ramsay Hunt syndrome. J Dtsch Dermatol Ges. 2012; 10(4):238- 43.
- Cihan YB, Turasan A. Kanserli hastalarda radyoterapi sonrası herpes zoster [Herpes zoster in cancer patients after radiotherapy]. Turkderm - Turk Arch Dermatol Venereol. 2013; 47(3):170-5.
- Kim SH, Jung J, Jung SY, Dong SH, Byun JY, Park MS, Kim SH, Yeo SG. Comparative prognosis in patients with Ramsay-Hunt syndrome and Bell’s palsy. Eur Arch Otorhinolaryngol. 2019; 276(4):1011-6.
- Kanerva M, Jones S, Pitkaranta A. Ramsay Hunt syndrome: Characteristics and patient self-assessed long-term facial palsy outcome. Eur Arch Otorhinolaryngol. 2020; 277(4):1235-45.
- Gross GE, Eisert L, Doerr HW, Fickenscher H, Knuf M, Maier P, Maschke M, Müller R, Pleyer U, Schäfer M, Sunderkötter C, Werner RN, Wutzler P, Nast A. S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia. J Dtsch Dermatol Ges. 2020; 18(1):55- 78.
- Gan EY, Tian EA, Tey HL. Management of herpes zoster and post-herpetic neuralgia. Am J Clin Dermatol. 2013; 14(2):77-85.
- Murakami S, Hato N, Horiuchi J, Honda N, Gyo K, Yanagihara N. Treatment of Ramsay Hunt syndrome with acyclovir-prednisone: Significance of early diagnosis and treatment. Ann Neurol. 1997; 41(3):353-7.
- Kim S, Jeon Y. Treatment of abdominal segmental hernia, constipation, and pain following herpes zoster with paravertebral block. Pain Physician. 2015; 18(5):E927-9.
Recommended Citation
Eninanç, İ., & Şahin, B. Ramsay Hunt Syndrome with Oral Findings: A Rare Case. J Dent Indones. 2023;30(1): 62-66
Included in
Cell and Developmental Biology Commons, Dental Public Health and Education Commons, Immunology and Infectious Disease Commons, Oral and Maxillofacial Surgery Commons, Oral Biology and Oral Pathology Commons