Anesth Pain Med.  2012 Jan;7(1):16-21.

Auriculotemporal and greater auricular nerve blocks have roles in patients with Ramsay Hunt syndrome with trigeminal nerve involvement: A report of two cases

• Jin HS
• Sim WS
• Roe HJ

Abstract

Ramsay Hunt syndrome (RHS) refers to herpes zoster infection of the geniculate ganglion of the facial nerve. Cases complicated by multicranial nerve involvement in the process of reactivation of the virus, which are known to show virulent clinical course and worse prognosis, are not common in literature as in practice, and there has been only one reported case of suspected co-involvement of the trigeminal nerve in Korean literature. Therefore, in cases of RHS with severe rash over the face and neck, it is pertinent to give consideration to such multiple involvement in their early presentation. Facial nerve palsy and herpes related pain are the two worrisome complication, which could be alleviated by early treatment with neural blockade in addition to oral medication. Especially, nerve blocks are known to decrease the extent of nerve inflammation or damage, thereby facilitating recovery and probably preventing postherpetic neuralgia. We report two rare cases of Ramsay Hunt syndrome with trigeminal nerve involvement, where early implementation of blockade of somatic peripheral nerve branches, in addition to the conventional treatment, promoted early recovery.

Keyword

Herpes zoster; Polyneuropathy; Ramsay Hunt syndrome; Somatic peripheral nerve branch block

MeSH Terms

Exanthema
Facial Nerve
Geniculate Ganglion
Herpes Zoster
Herpes Zoster Oticus
Humans
Inflammation
Neck
Nerve Block
Neuralgia, Postherpetic
Paralysis
Peripheral Nerves
Polyneuropathies
Prognosis
Trigeminal Nerve
Viruses