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J. Ramsay Hunt established the term herpes zoster oticus in 1907. This syndrome is caused by the reactivation of latent varicella-zoster virus (VZV) residing within the geniculate ganglion with subsequent spread of the inflammatory process to the seventh and eighth cranial nerves. Features may include ipsilateral facial paralysis, tinnitus, hearing loss, hyperacusis, vertigo, dysgeusia, decreased tearing, and ear pain. Characteristic vesicles are frequently seen in the external auditory canal, on the pinna, and less often on the anterior pillar of the fauces. In some patients, cranial nerves V, IX, and X are also involved. MRI often demonstrates segmental enhancement of the seventh and eighth cranial nerves, geniculate ganglion, and parts of the membranous labyrinth.1 We report a patient with Ramsay Hunt syndrome (RHS) in whom MRIs showed a T2-weighted hyperintense lesion involving the ipsilateral spinal trigeminal nucleus and tract (STNT).
Case report.
A 51-year-old man developed severe left ear pain 7 weeks before our evaluation. Five days later, he noted left-sided hearing loss, tinnitus, facial weakness, and dysgeusia. …
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