A case report of atypical Ramsay-Hunt Syndrome presented with severe vertigo and vomiting

Abstract

Ramsay-Hunt Syndrome (Herpes zoster oticus) is often characterized by severe ear pain, vesi-cles on external auditory canal or auricula and peripheral facial paralysis. However, the patient in this case presented to the clinic with dizziness, pain in the ear and vomiting. During the physical examination there was no vesicles and no evidence of skin changes found around the auricula that were typical for Ramsay Hunt syndrome. The patient did not have facial paralysis. If there is an unexpected severe ear pain accompanying vertigo, Ramsay Hunt syndrome should be con-sidered in the differential diagnosis even if there is no rash or facial paralysis.

Keywords

• Herpes zoster oticus
• Vertigo
• Vomiting
• Acyclovir

References

1. 1. Hunt JR.(1907) On herpetic inflations of the geniculate ganglion: A new syndrome and its complications. J New Ment Dis; 34: 73-96.
2. 2. Sweney CJ, Gilden DH.(2001) Ramsay Hunt Syndrome. J Neurol Neurosurg Psychia-try; 71: 149-54.
3. 3. Yetişer S, Tosun F, Satar B, Özkaptan Y.(2002) Herpes Zoster Oticusta Oral Asiklovir Tedavisi Sonuçları. Otoskop; 1: 19-23.
4. 4. Walter LE, Prosowsky K, Walther A, Gudziol H.(2004) Untersuchungen zum Zoster Oticus. Laryngo-Rhino-Otol; 83: 355-62.
5. 5. Schrader A, Stickel H.(1988) Virale und bakterielle Infektionen des Zentralnerven-system.In: Neundörfer B, Schimrigk K, Soyka D (eds): Praktische Neurologie, Band 6 Weinheim: VCH;149-57.
6. 6. Baba M, Seçkin D, Eryılmaz A, Gençay S.(2006) Atipik Seyirli Ramsay Hunt Sen-dromlu Bir Olgu. Türkderm; 40 (Özel ek B): B80-81.
7. 7. Kennedy PG.(2002) Varicella –Zoster virus latency in human ganglia. Rev Med Viral; 12: 327-34.
8. 8. de Mendonca Vaz, R., & Linthicum, F. H. (2009). Ramsay hunt syndrome: a histopath-ologic observation of a facial sequelae. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Acad-emy of Otology and Neurotology, 30(3), 428-9.

9. 9. Waldman RA, Waldman CW, Waldman SD (2015) Ramsay Hunt Syndrome Type 2: A Review of an Uncommon and Unwelcome Neurodermatologic Disease. J Otolaryngol Rhinol 1:003