Acyclovir responsive brain stem disease after the Ramsay Hunt syndrome

Hu, Shuching; Walker, Melanie; Czartoski, Todd; Cheng, Alan; Forghani, Bagher; Gilden, Donald H.; Garden, Gwenn A.

doi:10.1016/j.jns.2003.08.011

« Previous Next »Journal of the Neurological Sciences
Volume 217, Issue 1 , Pages 111-113, 15 January 2004

Acyclovir responsive brain stem disease after the Ramsay Hunt syndrome

Shuching Hu
- Department of Neurology, University of Washington, Box 356465, Seattle, WA 98195, USA
Melanie Walker
- Department of Neurology, University of Washington, Box 356465, Seattle, WA 98195, USA
Todd Czartoski
- Department of Neurology, University of Washington, Box 356465, Seattle, WA 98195, USA
Alan Cheng
- Department of Otolaryngology/Head and Neck Surgery, University of Washington, Seattle, WA, USA
Bagher Forghani
- Viral and Rickettsial Disease Laboratory, Division of Communicable Disease Control, California Department of Health Services, Richmond, CA, USA
Donald H. Gilden
- Departments of Neurology and Microbiology, University of Colorado Health Sciences Center, Denver, CO, USA
Gwenn A. Garden
- Corresponding author. Tel.: +1-206-616-9402; fax: +1-206-685-8100.
- Department of Neurology, University of Washington, Box 356465, Seattle, WA 98195, USA

Received 30 May 2003; received in revised form 22 August 2003; accepted 25 August 2003.

Abstract

We report an immunocompetent patient with the Ramsay Hunt syndrome (RHS) followed days later by brainstem disease. Extensive virological studies proved that varicella zoster virus (VZV) was the causative agent. Treatment with intravenous acyclovir resulted in prompt resolution of all neurological deficits except peripheral facial palsy. This case demonstrates that after geniculate zoster, brainstem disease may develop even in an immunocompetent individual and effective antiviral therapy can be curative.

Keywords: Varicella, Ramsay-hunt syndrome, Polymerase chain reaction, Cerebellum, Brain stem