Ann Rehabil Med.  2011 Oct;35(5):738-741. 10.5535/arm.2011.35.5.738.

Dysphagia in Ramsay Hunt's Syndrome: A Case Report

• Shim JH
• Park JW
• Kwon BS
• Ryu KH
• Lee HJ
• Lim WH
• Lee JH
• Park YG

• KMID: 2267239
• DOI: http://doi.org/10.5535/arm.2011.35.5.738

Abstract

Ramsay-Hunt syndrome is caused by varicella zoster virus infection in the geniculate ganglion of the facial nerve. It is characterized by facial palsy, otic pain, and herpetic vesicles around the auricle and external auditory canal. Additionally, symptoms may develop related to other cranial nerve involvement, such as dizziness or hearing loss by the vestibulocochlear nerve being invaded. We report a rare case of a Ramsay-Hunt syndrome patient who developed dysphagia due to multiple cranial nerve involvement including the glossopharyngeal nerve and vagus nerve.

Keyword

Herpes zoster oticus; Dysphagia; Facial paralysis

MeSH Terms

Cranial Nerves
Deglutition Disorders
Dizziness
Ear Canal
Facial Nerve
Facial Paralysis
Geniculate Ganglion
Glossopharyngeal Nerve
Hearing Loss
Herpes Zoster Oticus
Herpesvirus 3, Human
Humans
Vagus Nerve
Vestibulocochlear Nerve

Figure

• 

  Fig. 1 Clinical features. (A) No forehead motion is observed. (B) An asym metric mouth is noted with maximal effort. (C) Much discharge is observed in the external auditory canal. (D) Vesicles are noted on the anterior pillar, soft palate, and uvula.

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  Fig. 2 Contrast internal auditory canal MRI. (A) Contrast-enhanced axial T1-weighted image (onset) shows enhancement in the geniculate ganglion (arrow), cisternal and in ternal auditory canal segment of facial and vestibulocochlear nerve (arrowhead), and cisternal segment of the glossopharyngeal and vagus nerve (open arrow). (B) Contrast-enhanced axial T1-weighted image (2 months after onset) shows decreased enhancement in the geniculate ganglion (arrow), cisternal and internal auditory canal segments of facial and vestibulocochlear nerves (arrowhead), and cisternal segment of the glossopharyngeal and vagus nerves (open arrow).

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  Fig. 3 Video fluoroscopic swallowing study. (A) An anterior radiographic view of the pharynx illustrating residual barium on the right side of the pharynx in the pyriform sinus. (B) An anterior radiographic view of the pharynx with the head turned to the weaker side, illustrating the bolus flow down the opposite side of the pharynx.

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