Síndrome de Ramsay Hunt: relato de caso / Ramsay Hunt Syndrome: case report

A Síndrome de Ramsay Hunt é definida por paralisia facial periférica acompanhada de um rash eritematosoe vesicular no pavilhão auricular ou na boca, causado por herpes zoster. Comparado com a paralisia de Bell,os pacientes com Síndrome de Ramsay Hunt geralmente apresentam um quadro de paralisia mais grave e dificilmentese recuperam totalmente. Alguns estudos sugerem que o tratamento com aciclovir e predinisona possa melhorar o prognóstico, entretanto estudos randomizados ainda são necessários. Os autores descrevem um caso desta síndrome acompanhado de ceratopatia de exposição.

Ramsay Hunt Syndrome consists in facial peripheric paralysis associated with auricular or mouth rash andvesicles, caused by herpes zoster. Compared to Bell’s paralysis, the patients with Ramsay Hunt Syndrome usually present worse paralisy and hardly have a total recovery. Some studies suggest that acyclovir and prednisone treatment may improve the prognosis, but random control studies are still necessary. The authors describeone case of this syndrome with exposure keratopathy.

Correlation between MRI and Operative Findings in Bell's Palsy and Ramsay Hunt Syndrome

PURPOSE: To investigate the correlation between gadolinium enhanced magnetic resonance image (MRI) results and surgical findings of facial nerves in Bell's palsy and Ramsay Hunt syndrome. MATERIALS AND METHODS: From 1995 to 2004, MRI was performed on 13 patients with Bell's palsy or Ramsay Hunt syndrome, who were offered with surgical decompression of the facial nerve through the middle cranial fossa approach. Gadolinium enhanced MRI was performed on all patients and the enhancement of the facial nerve was evaluated by radiology specialists. Operative findings including the degree of the facial nerve segment swelling were examined. Furthermore, the time interval from the onset of palsy to surgery was evaluated. RESULTS: Swelling of facial nerve segments was found in patients with enhanced facial nerves from MRI. The swelling of the facial nerve in the labyrinthine segment in particular was identified in all patients with enhanced labyrinthine segments in MRI. The intraoperative swelling of geniculate ganglion of facial nerve was found in 78% of patients with enhanced facial segment in MRI (p=0.01). The intraoperative swelling of tympanic segment was observed from fourth to ninth weeks after the onset of palsy. CONCLUSION: MRI enhancement of facial nerves in Bell's palsy and Ramsay Hunt syndrome is associated with the extent of intratemporal lesions of facial nerves, especially in the labyrinthine segment.

Síndrome de ramsay-hunt: a propósito de un case en el Hospital Militar "Cap. (AV)(F) Guilllermo Hernández Jacobsen" / Syndrome of ramsay-hunt: a purpose of a case in the Hospital Militar

El síndrome de Ramsay Hunt, es una causa infecciosa de parálisis del nervio facial, teniendo actualmente una incidencia de 15 a 40 casos por 100000 habitantes. El objetivo del presente trabajo, es dar a conocer esta patología así como establecer pautas de tratamiento. Realizamos una revisión bibliográfica, efectuando una actualización del mismo. La mayor incidencia esta en los 40 y 60 años, no encontrando distinción en la incidencia entre hombre y mujeres, generalmente existe remisión total de la enfermedad, este síndrome es el principal responsable de la parálisis de Bell. El tratamiento debe consistir en antivirales. Todo paciente portador de parálisis de Bell deberá ser revisado en busca de lesiones herpeticas que comprometan el trayecto inervado por el octavo y séptimo par craneal, así como esta indicado se le practiquen, pruebas inmunológicas, tales como la reacción de cadena de polimerasas para virus de la varicela-zoster, Debe ser tratado con antivirales, a dosis similares a las empleadas en la primo infección por virus del herpes, así como se incluirán esteroides para su tratamiento ya que la fisiopatología es debida al proceso inflamatorio. Siendo esta patología poco conocida por el personal de salud, nos proponemos a difundir nuestra actualización y resultados encontrados