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Vestibuloneuritis Developed Concurrently in Ipsilateral Site with Herpes-Zoster Oticus Syndrome
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Gyu Cheol Han, Ju Hyoung Lee, Joo Hyun Woo, Jung Kook Yoo, Sun Hwa Lim
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J Korean Bal Soc. 2004;3(1):187-191.
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 Abstract
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- Background
: Acute vestibular neuronitis is the disease of which the etiology and pathophysiology are largely
unknown . But the viral infection and ischemia of the labyrinth and the vestibular nerve are considered as general
etiology. This study was performed to support the viral infection rather than the ischemic theory.
Materials & Methods : We studied seventy years old female patient who showed painful vesicles on left auricle
and vertigo with spontaneous nystagmus to the right side. We performed physical examination, serologic test, ENG test,
pure tone audiogram, brain magnetic resonance imaging and polymerase chain reaction.
Results
: We found small vesicles and vascular injection in left EAC, herpes zoster IgG positive, spontaneous right
beating in electronystagmograpy, 54% left canal paresis in Caloric test , decreasing left side Tc in velocity step rotatory
test, decresed gain, deviation to left in symmetry and phase lead in sinusoidal harmonic acceleration test, normal range
hearing in pure tone audiogram, microangiopathy on cortex in brain MRI and negative PCR.
Conclusion
: This case supports viral infection etiology rather than ischemia in vestibular neuritis. But more studies
to find the etiology of vestibular neuronitis are required.
Key Words : Herpes zoster oticus, Vestibular neuronitis.
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Evaluation of Vestibular Function in Ramsay Hunt Syndrome
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Gyu Cheol Han, Jung Kook Yoo, Kyu Sung Kim
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J Korean Bal Soc. 2003;2(2):202-205.
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Abstract
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- Background
and Objectives: Ramsay Hunt syndrome is herpes zoster of the facial nerve, frequently associated with VIII cranial nerve involvement, but on rare occasions other cranial nerves are affected as well. We tried to show that Ramsay Hunt symdrome should be recognized as a cranial polyneuropathy characterized by damage to cranial nerves, especially the facial nerve and the auditory-vestibular nerve.
Materials and Method: 11patients suffered from auricular vesicles, otalgia, facial palsy, and vertigo. Group A included 8 patients of acute peripheral vestibulopathy with Ramsay Hunt syndrome. Group B included only 3patients of Ramsay Hunt syndrome. Each patient received a battery of tests, including neurological examination, audiometry, vestibular function test.
Results
The lesion site of Ramsay HHhhunt syndrome was right in 5cases and left in 6cases. Electronystagmography showed 3cases of right acute peripheral vestibulopathy, 5cases of left, and 3cases of disequilibrium. Site of Ramsay hunt syndrome and that of vestibulopathy was same in 8cases of Group A. 3cases was observed in Ramsay Hunt syndrome patients that hearing loss and vestibulopathy was same site. Facail nerve palsy improved without recovery of vestibular function. Cranial examination and imaging study like brain CT or temporal MRI showed no abnormal finding.
Conclusion
Although Ramsay Hunt syndrome usually presents with the classical triad of pain, vesicles and facial nerve paralysis, it must be kept in mind that it is a cranial polyneuropathy. In our study, there was few association between facial nerve palsy recovery and acute peripheral vestibulopathy.
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KBS
