J Clin Neurol.  2006 Sep;2(3):198-201. 10.3988/jcn.2006.2.3.198.

A Case of Ramsay Hunt Syndrome Complicated by Cerebellitis

• Park HK
• Lee JH

• KMID: 2287694
• DOI: http://doi.org/10.3988/jcn.2006.2.3.198

Abstract

Cerebellitis associated with herpes zoster has rarely been observed. We report here a 76-year-old man who had a history of anterior resection for sigmoid colon cancer and presented during chemotherapy with vesicular rash of the left ear, neuralgic pain in the postauricular area, and ataxic gait. After a while, he developed left peripheral facial palsy, fever, aggravated gait ataxia, and prolonged nausea and vomiting. The left facial nerve was enhanced on gadolinium-enhanced brain magnetic resonance imaging. We suspected that the patient had Ramsay Hunt syndrome accompanied by cerebellitis, which has not been reported previously. Over the course of several months, during which he was treated with acyclovir and corticosteroid, his symptoms improved significantly.

Keyword

Varicella zoster virus; Ramsay Hunt syndrome; Cerebellitis

MeSH Terms

Acyclovir
Aged
Brain
Drug Therapy
Ear
Exanthema
Facial Nerve
Facial Paralysis
Fever
Gait
Gait Ataxia
Herpes Zoster
Herpes Zoster Oticus*
Herpesvirus 3, Human
Humans
Magnetic Resonance Imaging
Nausea
Sigmoid Neoplasms
Vomiting
Acyclovir

Figure

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  Figure 1 An erythematous-based vesicular rash on the left ear.

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  Figure 2 Postcontrast T1-weighted axial magnetic resonance imaging (MRI). The initial brain MRI (A, B) was unremarkable. Follow-up MRI (C, D) performed 2 weeks later showed gadolinium-contrast enhancement of the labyrinthine segment, genu, and proximal tympanic segment of the left facial nerve (arrow). No parenchymal lesions were found in the cerebellum.

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