Investig Magn Reson Imaging.  2021 Sep;25(3):197-200. 10.13104/imri.2021.25.3.197.

Early Diagnosis of Aseptic Meningitis in Ramsay Hunt Syndrome on 10-Minute Delayed CE 3D FLAIR Image: a Case Report

• Kang MH
• Kim DM
• Lee IH
• Song CJ

• KMID: 2520445
• DOI: http://doi.org/10.13104/imri.2021.25.3.197

Abstract

Ramsay Hunt syndrome (RHS) is a disease caused by varicella-zoster virus (VZV) infection that can be diagnosed through clinical symptoms with or without imaging evaluations. The typical features of RHS on imaging evaluation include signal changes and enhancement in the internal auditory canal (IAC) nerves, and the labyrinthine segment of cranial nerve VII (CN VII) and cranial nerve VIII (CN VIII). In some patients, inner ear structure (cochlear and vestibular apparatus) is involved in RHS. Neurologic complications, such as encephalitis and meningitis, are rare in RHS, but are known to occur. Therefore, magnetic resonance imaging (MRI) is necessary to detect both abnormal signal intensity in the IAC, CN VII, CN VIII, inner and ear structure, and CNS complications. We report an RHS patient with CN VII, VIII, and leptomeningeal enhancement within the cerebellar folia on 10-min delayed, contrast-enhanced (CE), three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) imaging.

Keyword

Ramsay Hunt Syndrome; Magnetic resonance imaging; 3D fluid-attenuated inversion recovery; Internal auditory canal; 10-minute delayed 3D fluid-attenuated inversion recovery