Recently, we have experienced three cases of Ramsay Hunt syndrome associated with central disorder at our department. Case 1 was in a 38-year-old man, who had the complaint of right hearing impairment and right facial palsy and was diagnosed as right Ramsay Hunt syndrome, thus was admitted in our hospital. The day after the admission, numbness dyskinesia occurred abruptly on the right half of the body, and CT scan revealed right thalamo and left cerebellar infarcted lesions. This patient had accompanying diabetes mellitis, but zoster virus vasculitis may also have let to the infarcted lesions.
Case 2 was in a 43-year-old man, who had the compalint of right facial palsy, vertigo and right hearing impairment and was admitted in our hospital under the diagnosis of right Ramsay Hunt syndrome. Three days after the admission, high fever, headache and stiffness of neck appeared. Cerebrospinal fluid examination revealed a remarkable increase in cell count, thus be was diagnosed as zoster virus meningitis. Treatment with aciclovir resulted in rapid improvement.
Case 3 was in a 58-year-old man, admitted to our hospital complaining of right facial palsy, vertigo and right hearing impairment and was diagnosed as right Ramsay Hunt syndrome for a detected right auricular herpes, thus was admitted in our hospital. From the tenth day after the admission, ataxic gait occurred, vertigo became strong and cerebrospinal fluid examination disclosed a remarkable increase in cell count, thus he was transfered to the department of neuro-internal medicine of our hospital under the diagnosis of brainstem encephalitis.
Such severe complications as mentioned above must be taken into consideration in the treatment of Ramsay Hunt syndrome.