Ramsay Hunt syndrome

Ramsay Hunt syndrome (RMS), also known as herpes zoster oticus, is shingles of the facial nerve. It is due to reactivation of the varicella zoster virus in the geniculate ganglion.

Ramsay Hunt syndrome classically presents with a triad of 3,4:

  • otic pain
  • facial nerve palsy
  • a vesicular eruption (often painful) involving the external auditory canal, pinna, tongue or hard palate

There may be involvement of the vestibulocochlear nerve (CN VIII) in which case vertigosensorineural hearing loss, and tinnitus may be present.

The syndrome is due to latent infection of the geniculate ganglion with varicella zoster virus and subsequent reactivation.

Imaging is identical to that seen in Bell palsy, with increased enhancement of the facial nerve. Care should be taken not to mistake normal facial nerve enhancement on MRI for that observed in Ramsay Hunt syndrome.

This eponymous syndrome was named after James Ramsay Hunt, an American neurologist (1872-1937) 2.

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Article information

rID: 1957
Section: Syndromes
Tag: refs, cases
Synonyms or Alternate Spellings:
  • Herpes zoster oticus
  • Ramsay-Hunt syndrome

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