Vol.97 No.9 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 97 No.9 September 2004
A Case of Ramsay Hunt Syndrome Followed by
Cerebellar Encephalitis
Kazuhiro Yamakawa, Masashi Hamada and Taizo Takeda
(Kochi Medical School)
We report a case of Ramsay Hunt syndrome followed by cerebellar encephalitis. A 69-year-old man with concomitant presentation of right severe facial palsy, ipsilateral auricular vesicle and vertigo was referred to our hospital under a diagnosis of Ramsay Hunt syndrome. A high dose of steroid and a conventional dose of acyclovir were administered from the second day of the disease onset. He quickly recovered from the vertigo, but the facial palsy persisted. He also exhibited an ataxic gait several days after the primary treatment. An increase in cell count, protein and VZV Ig-G in the cerebrospinal fluid led to a diagnosis of VZV-associated cerebellitis, even though VZV DNA was negative on PCR. Twice the previous doses of steroid and acyclovir each was administered and thereafter his walking ability improved. Care for central nerve complication should be taken in cases with VZV reactivation.
Key words : Ramsay Hunt syndrome, cerebellitis, facial palsy, acyclovir, varicella-zoster virus