Síndrome de Ramsay-Hunt causante de parálisis laríngea / Ramsay-Hunt syndrome presenting laryngeal paralysis

El síndrome de Ramsay-Hunt consiste en la asociación de parálisis facial periférica (PFP) e infección por virus varicela zoster (VVZ) con afectación del conducto auditivo externo y membrana timpánica. Se puede acompañar de sordera, acúfenos y vértigos. En ocasiones puede afectar los pares craneales bajos. Se presenta el caso de un paciente inmunocompetente con afectación de los pares craneales VII, VIII y X (AU)

The Ramsay-Hunt syndrome is the association of facial palsy and varicella-zoster virus infection with involvement of the ear canal and eardrum. It may be associated with deafness, tinnitus and dizziness. It can sometimes affect the lower cranial nerves. A case of an immunocompetent patient with affectation of the VII, VIII and X cranial nerves is presented (AU)

[Ramsay-Hunt syndrome presenting laryngeal paralysis]. / Síndrome de Ramsay-Hunt causante de parálisis laríngea.

The Ramsay-Hunt syndrome is the association of facial palsy and varicella-zoster virus infection with involvement of the ear canal and eardrum. It may be associated with deafness, tinnitus and dizziness. It can sometimes affect the lower cranial nerves. A case of an immunocompetent patient with affectation of the VII, VIII and X cranial nerves is presented.

Vértigo posicional paroxístico benigno: análisis de nuestra población y del papel de las pruebas calóricas / Benign paroxysmal positional vertigo: analysis of our population and role of caloric tests

Introducción y objetivos: El vértigo posicional paroxístico benigno (VPPB) es la causa más frecuente de vértigo diagnosticada en los pacientes que buscan asistencia médica. Aunque inicialmente plantear un estudio con videonistagmografía parece lo más indicado, en nuestro medio hemos tratado de disminuir el número de pruebas calóricas solicitadas para optimizar los recursos y disminuir los costes asociados. Métodos: Para evaluar la necesidad de realizar pruebas calóricas en estos pacientes, hemos elaborado un algoritmo diagnóstico-terapéutico para enfermos con sospecha de VPPB en los que las pruebas de provocación son positivas y hemos analizado los resultados de su aplicación sobre 98 pacientes que durante 15 meses fueron derivados a nuestra consulta de Otoneurología para que se les realizara una videonistagmografía con estimulación bitérmica binaural. Resultados: Hemos conseguido reducir las videonistagmografías practicadas a un 24% de las solicitadas. Al comparar nuestro índice de recurrencia tras un año de seguimiento con los de otra serie de pacientes españoles, no hemos obtenido diferencia significativa. Conclusiones: La videonistagmografía no es estrictamente necesaria en la mayoría de los pacientes con VPPB, debiendo reservarse para los casos de duda diagnóstica (AU)

Introduction and objectives: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo in those patients who seek medical care. Although videonystagmography seems the most indicated diagnostic test, we tried to decrease the requested caloric tests to optimise resources and reduce associated costs. Methods: We developed a diagnostic-therapeutic algorithm for patients with suspected BPPV whose provocation tests are positive to evaluate the need for caloric testing. We analysed the results of its application on 98 patients who were referred to our Neuro-otology Unit over 15 months requesting videonystagmography and caloric tests. Results: Only 24% of the requested tests were performed. No significant difference was found in our recurrence rate compared with other series of Spanish patients. Conclusions: Videonystagmography and caloric tests are not strictly necessary in most patients with BPPV and they should be performed only in patients whose diagnosis is unclear (AU)

[Benign paroxysmal positional vertigo: analysis of our population and role of caloric tests]. / Vértigo posicional paroxístico benigno: análisis de nuestra población y del papel de las pruebas calóricas.

INTRODUCTION AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo in those patients who seek medical care. Although videonystagmography seems the most indicated diagnostic test, we tried to decrease the requested caloric tests to optimise resources and reduce associated costs. METHODS: We developed a diagnostic-therapeutic algorithm for patients with suspected BPPV whose provocation tests are positive to evaluate the need for caloric testing. We analysed the results of its application on 98 patients who were referred to our Neuro-otology Unit over 15 months requesting videonystagmography and caloric tests. RESULTS: Only 24% of the requested tests were performed. No significant difference was found in our recurrence rate compared with other series of Spanish patients. CONCLUSIONS: Videonystagmography and caloric tests are not strictly necessary in most patients with BPPV and they should be performed only in patients whose diagnosis is unclear.