Ramsay-Hunt Syndrome - An Unusual Presentation

Neurotrophic corneal ulcer and iridocyclitis directly preceding Ramsay-Hunt Syndrome

“…The authors concluded that the ophthalmologist should monitor the fundus for retinitis in patients with RHS. 6 Lastly, a patient was reported to have sequential RHS, HZO and disseminated-cutaneous herpes zoster, which more commonly happens in immunocompromised patients, but can rarely occur in immunocompetent. The authors suggested a similar mechanism as with our patient, that the affected sensory nerves can affect adjacent cranial nerves through anastomoses in the brainstem and even the spinal ganglia.…”

“… 2 , 3 , 4 Herpes zoster ophthalmicus (HZO) with necrotizing retinitis, neurotrophic keratitis, and exposure keratitis have all been reported following the RHS presentation, usually along with vesicular lesions in the V1–V3 dermatomes. 5 , 6 Our case is the first known case of neurotrophic keratitis and iridocyclitis, which are common sequela of herpes zoster reactivation in the eye, with facial palsy and vesicular lesions in the ear canal occurring subsequently. This would suggest that VZV reactivation in the trigeminal ganglion can also descend to the geniculate ganglion and cause RHS.…”