Nystagmus in Ramsay Hunt syndrome with or without dizziness

Choi, Byeong Yoon; Noh, Haemin; Jeong, Hamin; Shin, Jung Eun; Kim, Chang-Hee

doi:10.1007/s10072-020-04536-w

Cited by 5 publications

(5 citation statements)

References 28 publications

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“…While the enhancement is generally localized within the facial nerve in BP, the enhancement, as shown in the present study (Fig. 2), has been observed in not only the facial nerve but also the vestibulocochlear nerve on temporal bone MRI in RHS [12][13][14][15]20,[27][28][29][30][31][32] . Enhancement of the inner ear organs has been frequently observed in RHS 12,13,15,19,20,27,29,30,33 , and dural enhancement along the IAC, as shown in the present study (Fig.…”

Section: Discussionsupporting

confidence: 62%

Mastoid effusion on temporal bone MRI in patients with Bell’s palsy and Ramsay Hunt syndrome

Choi

Lee

et al. 2021

Sci Rep

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This study aimed to investigate the incidence of mastoid effusion on temporal bone magnetic resonance imaging (MRI) in patients with Bell’s palsy (BP) and Ramsay Hunt syndrome (RHS), and evaluate the usefulness of mastoid effusion in early differential diagnosis between BP and RHS. The incidence of mastoid effusion on 3.0 T—temporal bone MRI, which was conducted within 10 days after the onset of acute facial nerve palsy, was compared between 131 patients with BP and 33 patients with RHS. Findings of mastoid cavity on temporal bone MRI were classified into three groups as normal mastoid, mastoid effusion, and sclerotic change, and the incidence of ipsilesional mastoid effusion was significantly higher in RHS than BP (P < 0.001). Tympanic membrane was normal in 7 of 14 RHS patients with mastoid effusion, and injected without middle ear effusion in 7 patients. This study highlights significantly higher incidence of ipsilesional mastoid effusion in RHS than BP, and suggests that the presence of mastoid effusion may provide additional information for differential diagnosis between RHS and BP.

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Section: Discussionsupporting

confidence: 62%

Mastoid effusion on temporal bone MRI in patients with Bell’s palsy and Ramsay Hunt syndrome

Choi

Lee

et al. 2021

Sci Rep

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“…Our patients showed very weak, persistent positional direction-changing nystagmus, of which the direction was geotropic in Case 1 and apogeotropic in Case 2. This type of positional nystagmus has been reported in other inner ear disorders [19][20][21][22][23][24], and it could not be clearly explained by typical BPPV [25]. The change in chemical composition and/or electrolyte concentration in the inner ear fluid, although still unclear, may underlie the production of this characteristic nystagmus in these patients.…”

Section: Discussionmentioning

confidence: 71%

Positional Nystagmus after Acute Vertiginous Attack in Meniere’s Disease

et al. 2021

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There have been no reports regarding nystagmus observed immediately after the end of an acute vertiginous attack in patients with Meniere’s disease. The aim of this study was to demonstrate positional direction-changing nystagmus in patients with Meniere’s disease, and to discuss the mechanism that underlies this nystagmus. Video-nystagmography was recorded in two patients with definite Meniere’s disease, who showed positional direction-changing nystagmus during the period immediately after a vertigo attack. In one patient, video-nystagmographic recording was conducted 5 h after an episode of vertigo attack, and it showed very weak, persistent positional geotropic direction-changing nystagmus. In the other patient, video-nystagmographic recording was conducted 23 h after an episode of vertigo attack, and it showed very weak, persistent positional apogeotropic direction-changing nystagmus. Our patients exhibited very weak, persistent positional direction-changing nystagmus, which was geotropic in one and apogeotropic in the other. This type of positional nystagmus has been reported in other inner ear disorders and it cannot be clearly explained by typical benign paroxysmal positional vertigo. The change in chemical composition and/or electrolyte concentration of the inner ear fluid, although still unclear, may underlie the production of this characteristic nystagmus in these patients.

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“…Lee et al studied the presence of nystagmus in RHS with and without dizziness; in 96% of patients reporting vestibular symptoms, they found a spontaneous nystagmus, while in 67% of patients without dizziness, nystagmus was of weaker intensity [27]. The presence of vertigo and nystagmus does not seem to be related to viral load, since no significant difference in maximum viral copy number between patients with and without cochlea-vestibular symptoms was found in the saliva of patients with RHS [28].…”

Section: Resultsmentioning

confidence: 99%

Cochleo-Vestibular Disorders in Herpes Zoster Oticus: A Literature Review and a Case of Bilateral Vestibular Hypofunction in Unilateral HZO

Teggi,

Del Poggio,

Cangiano

et al. 2023

JCM

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The varicella-zoster virus (VZV), a member of the Herpesviridae family, causes both the initial varicella infection and subsequent zoster episodes. Disorders of the eighth cranial nerve are common in people with herpes zoster oticus (HZO). We performed a review of the literature on different databases including PubMed and SCOPUS, focusing on cochlear and vestibular symptoms; 38 studies were considered in our review. A high percentage of cases of HZO provokes cochlear and vestibular symptoms, hearing loss and vertigo, whose onset is normally preceded by vesicles on the external ear. It is still under debate if the sites of damage are the inferior/superior vestibular nerves and cochlear nerves or a direct localization of the infection in the inner ear. The involvement of other contiguous cranial nerves has also been reported in a few cases. We report the case of a patient with single-side HZO presenting clinical manifestations of cochleo-vestibular damage without neurological and meningeal signs; after 15 days, the patient developed a new episode of vertigo with clinical findings of acute contralateral vestibular loss. To our knowledge, only three other such cases have been published. An autoimmune etiology may be considered to explain these findings.

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Nystagmus in Ramsay Hunt syndrome with or without dizziness

Cited by 5 publications

References 28 publications

Mastoid effusion on temporal bone MRI in patients with Bell’s palsy and Ramsay Hunt syndrome

Mastoid effusion on temporal bone MRI in patients with Bell’s palsy and Ramsay Hunt syndrome

Positional Nystagmus after Acute Vertiginous Attack in Meniere’s Disease

Cochleo-Vestibular Disorders in Herpes Zoster Oticus: A Literature Review and a Case of Bilateral Vestibular Hypofunction in Unilateral HZO

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