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Prognosis of ramsay hunt syndrome presenting as cranial polyneuropathy
Author(s) -
Kim Young Ho,
Chang Moon Young,
Jung Hak Hyun,
Park Yong Soo,
Lee Seung Hwan,
Lee Jun Ho,
Oh SeungHa,
Chang Sun O,
Koo JaWon
Publication year - 2010
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.21108
Subject(s) - medicine , ramsay hunt syndrome , cranial nerves , cranial nerve palsy , polyneuropathy , surgery , hearing loss , cranial nerve disease , palsy , facial nerve , facial paralysis , retrospective cohort study , facial nerve palsy , pathology , audiology , eye disease , alternative medicine
Abstract Objectives/Hypothesis: Ramsay Hunt syndrome is known to be accompanied with cranial polyneuropathy very occasionally. We reviewed our experience to analyze the clinical manifestations and prognosis of these cases. Study Design: Retrospective review. Methods: Eleven patients with Ramsay Hunt syndrome presenting as cranial polyneuropathy between 1999 and 2009 were included in this study retrospectively. All patients were treated with systemic steroids and antiviral agents. Assessment of recovery from facial nerve palsy (FNP) using the House‐Brackmann (HB) grading system was performed, and the follow‐up period was 4 to 28 months. Results: The patient numbers for the initial degree of FNP were five for HB grade II, one for grade III, two for grade IV, and three for grade V. The cochleovestibular nerve was involved in 10 cases, and hearing loss was observed in nine patients. Other involved cranial nerves were IX in seven cases, X in five cases, V in three cases, and III/XII in one case each. Antiviral agents and steroids were administered within 3 days after the onset of symptoms for about 1 to 2 weeks in most cases. After the treatment the degree of FNP improved to HB grade I or II in nine of 11 patients (81.8%). Symptoms of other cranial nerves also improved in most patients, whereas recovery for hearing loss showed poor results. Conclusions: Ramsay Hunt syndrome associated with cranial polyneuropathy has a good prognosis for FNP and other cranial nerve palsies with a combination therapy of antiviral agents and steroids, but not for recovery of hearing loss. Laryngoscope, 2010