"Facial palsy' in Herpes Zoster infection is seen in
(A) Ramsay Hunt syndrome # Herpes zoster oticus (HZ oticus) is a viral infection of the inner, middle, and external ear. HZ oticus manifests as severe otalgia and associated cutaneous vesicular eruption, usually of the external canal and pinna.> When associated with facial paralysis, the infection is called Ramsay Hunt syndrome.> Pathophysiology: Reactivation of the varicella-zoster virus (VZV) along the distribution of the sensory nerves innervating the ear, which usually includes the geniculate ganglion, is responsible for HZ oticus. Associated symptoms such as hearing loss and vertigo are thought to occur as a result of transmission of the virus via direct proximity of cranial nerve (CN) VIII to CN VII at the cerebellopontine angle or via vasa vasorum that travel from CN VII to other nearby cranial nerves.> If diagnosis of Ramsay Hunt syndrome is not established by physical examination alone, consider a head CT scan to investigate other etiologies of facial paralysis.> Early administration (<72 h) of acyclovir showed an increased rate of facial nerve function recovery and prevented further nerve degeneration. Evidence is accumulating that VZV may be responsible for many cases of Bell palsy that go unrecognized because of a lack of cutaneous findings (zoster sine herpete).> Accordingly, the clinician should entertain more liberal use of antivirals such as acyclovir, valacyclovir, and famciclovir. Systemic corticosteroids are used to relieve acute pain, decrease vertigo, and limit the occurrence of postherpetic neuralgia, although evidence proving benefit attributed specifically to steroids is still limited.
Ramsay Hunt syndrome
Meckerson Rosenthal syndrome
Sturge Weber syndrome
Guillian Barre syndrome
Miscellaneous (E.N.T.)