Res Vestib Sci.  2022 Jun;21(2):57-62. 10.21790/rvs.2022.21.2.57.

A Case of Pontine Infarction with Facial Palsy and Vertigo Confused with Ramsay Hunt Syndrome

• Park JS
• Kim SH
• Lee JY
• Kim MB

• KMID: 2530630
• DOI: http://doi.org/10.21790/rvs.2022.21.2.57

Abstract

Facial palsy can be caused by central and peripheral causes, and it can also be caused by brain tumors or infarction. A 59-year-old male, who lost his right hearing 13 years ago due to Ramsay Hunt syndrome, visited our hospital with facial palsy and dizziness. Initial brain diffusion-weighted magnetic resonance imaging (MRI) showed no abnormal findings, and recurrent Ramsay Hunt syndrome or a neoplastic lesion in the internal auditory canal was suspected. After hospitalization, the patient was administered high-dose steroids, and the videonystagmography showed direction-changing gaze-induced nystagmus, so a brain MRI reexamination was scheduled. While waiting for MRI, the patient complained of neurological symptoms such as diplopia, and right lower pontine infarction was diagnosed on MRI. The patient was transferred to the neurologic department and was discharged on the 10th day after conservative treatment. During the 1-year follow-up, pontine infarction did not recur, and neurological symptoms such as facial palsy gradually improved.

Keyword

Facial paralysis; Dizziness; Brain stem infarctions; Pons; Herpes zoster oticus; 안면마비; 어지럼; 뇌간 경색; 뇌교; 이성 대상포진