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viral diseases causing eruptions of the skin or mucous membrane
any of the animal viruses that cause painful blisters on the skin (同)herpes_virus
of or relating to near the ear (同)auricular

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疱疹(ほうしん)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/24 00:29:49」(JST)

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Ramsay Hunt syndrome (RHS) type 2 also known as herpes zoster oticus is a disorder that is caused by the reactivation of pre-existing Varicella zoster virus in the geniculate ganglion, a nerve cell bundle, of the facial nerve.^[1]

Ramsay Hunt syndrome type 2 typically presents with inability to move many facial muscles, pain in the ear, taste loss on the front of the tongue, dry eyes and mouth, and the eruption of an erythematous rash.

Signs and symptoms

The symptoms and signs include acute facial nerve paralysis, pain in the ear, taste loss in the front two-thirds of the tongue, dry mouth and eyes, and eruption of an erythematous vesicular rash^[2] in the ear canal, the tongue, and/or hard palate.

Since the vestibulocochlear nerve is in proximity to the geniculate ganglion, it may also be affected, and patients may also suffer from tinnitus, hearing loss, and vertigo.

Possible involvement of the trigeminal nerve can cause numbness of the face.

Pathophysiology

RHS type 2 refers to shingles of the geniculate ganglion. After initial infection, varicella zoster virus lies dormant in various nerve cells in the body, where it is kept in check by the patient's immune system. Given the opportunity, for example during an illness that suppresses the immune system, the virus is reactivated and travels to the end of the nerve cell, where it causes the symptoms described above.^{[citation needed]}

In RHS type 2, the affected ganglion is responsible for the movements of facial muscles, the touch sensation of a part of ear and ear canal, the taste function of the frontal two-thirds of the tongue, and the moisturization of the eyes and the mouth. The syndrome specifically refers to the combination of this entity with weakness of the muscles activated by the facial nerve. In isolation the latter entity would be called Bell's Palsy.^{[citation needed]}

Like shingles, however, lack of lesions does not definitely exclude the existence of a herpes infection. The virus can be detected, even before the eruption of vesicles, from the skin of the ear.^[3]

Prevention

This disease is prevented by immunizing against the causal virus, varicella zoster, for example through Zostavax, a stronger version of chickenpox vaccine.

Treatment with the corticosteroid Prednisone and acyclovir has been shown to achieve complete recovery in a majority of patients if started within the first three days of facial paralysis, ^[4] with chances of recovery decreasing as treatment was delayed. Delay of treatment may result in permanent facial nerve paralysis.^{[citation needed]}

Treatment apparently has no effect on the recovery of hearing loss.^{[citation needed]}

Diazepam is sometimes used to treat the vertigo.^[5]

History

It is named after James Ramsay Hunt.^[6]^[7]

References

^ Hunt JR (1907). "On herpetic inflammations of the geniculate ganglion: a new syndrome and its complications". J Nerv Ment Dis 34 (2): 73–96. doi:10.1097/00005053-190702000-00001.
^ Sweeney CJ, Gilden DH (August 2001). "Ramsay Hunt syndrome". J. Neurol. Neurosurg. Psychiatr. 71 (2): 149–54. doi:10.1136/jnnp.71.2.149. PMC 1737523. PMID 11459884.
^ Murakami S, Honda N, Mizobuchi M, Nakashiro Y, Hato N, Gyo K (1998). "Rapid diagnosis of varicella zoster virus infection in acute facial palsy". Neurology 51 (4): 1202–5. doi:10.1212/wnl.51.4.1202. PMID 9781562.
^ Murakami, Shingo; Hato, Naohito; Horiuchi, Joji; Honda, Nobumitsu; Gyo, Kiyofumi; Yanagihara, Naoaki (1 March 1997). "Treatment of ramsay hunt syndrome with acyclovir-prednisone: Significance of early diagnosis and treatment". Annals of Neurology 41 (3): 353–357. doi:10.1002/ana.410410310.
^ NINDS Herpes Zoster Oticus Information Page at NINDS
^ synd/2246 at Who Named It?
^ "THE RAMSAY HUNT syndrome". Proc. R. Soc. Med. 47 (5): 371–84. May 1954. PMC 1918846. PMID 13167057.

External links

Ramsay Hunt syndrome at GPnotebook
NINDS Herpes Zoster Oticus Information Page National Institute of Neurological Disorders and Stroke
Ramsay-Hunt Syndrome. Support site.
drtbalu otolaryngology on line
Ramsay Hunt Syndrome Causes, Symptoms, Diagnoses
Vaccine at Centers for Disease Control and Prevention
MR scans Imaging Zoster Oticus

UpToDate Contents

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1. 水痘帯状疱疹ウイルス感染症の臨床症状：帯状疱疹 clinical manifestations of varicella zoster virus infection herpes zoster
2. 免疫正常患者における帯状疱疹の治療 treatment of herpes zoster in the immunocompetent host
3. 小児における顔面神経麻痺 facial nerve palsy in children
4. ベル麻痺：成人における病因、臨床的特徴、および診断 bells palsy pathogenesis clinical features and diagnosis in adults
5. 回転性めまいの病態生理、病因、および鑑別診断 pathophysiology etiology and differential diagnosis of vertigo

English Journal

Test Battery of Cranial Nerves VII and VIII for Assessing Herpes Zoster Oticus.

Huang YC1, Wang SJ1, Young YH2.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.Otolaryngol Head Neck Surg.2014 Nov 10. pii: 0194599814557614. [Epub ahead of print]
OBJECTIVE: This study adopted a test battery of cranial nerves (CNs) VII and VIII comprising a facial nerve function test, audiometry, a caloric test, and ocular and cervical vestibular-evoked myogenic potential (oVEMP and cVEMP, respectively) tests to assess the function of CNs VII and VIII compreh
PMID 25385809

[Three cases of Ramsay-Hunt syndrome concurrent with ipsilateral vocal cord paralysis].

Zhan J, Fu Z, Wei X.
Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery.Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi.2014 Apr;28(8):578-9.
The clinical data of 3 cases of Ramsay-Hunt syndrome concurrent with ipsilateral vocal cord paralysis were retrospectively analyzed, and the relevant literatures were also reviewed. Ramsay-Hunt syndrome is a kind of disease characterized by heavy ear pain, herpes zoster oticus and inner ear neurolog
PMID 25007684

Neurologic syndromes of the head and neck.

Dorsch JN.
Primary care.Prim Care.2014 Mar;41(1):133-49. doi: 10.1016/j.pop.2013.10.012.
Although patients with Bell palsy and trigeminal neuralgia occasionally present to primary care physicians, most of the syndromes in this article are somewhat rare in primary care practice. It is important to recognize signs and symptoms of these syndromes so that appropriate management is carried o
PMID 24439887

Japanese Journal

膀胱直腸障害を伴った帯状疱疹の2例

皮膚の科学 13(2), 93-96, 2014
NAID 130004679571

激しい回転性めまいと嘔吐で発症した不全型 Ramsay-Hunt 症候群の1例

脳と発達 44(1), 66-68, 2012-01-01
NAID 10030291360

耳帯状疱疹が遅発した5歳児ハント症候群例

耳鼻咽喉科臨床 104(3), 175-179, 2011-03-01
NAID 10027794096

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★リンクテーブル★

リンク元	「耳帯状疱疹」「耳帯状ヘルペス」「耳性帯状病疹」「耳性帯状疱疹」「耳ヘルペス」
関連記事	「otic」

「耳帯状疱疹」

Ramsay Hunt syndrome (RHS) type 2
Classification and external resources
Specialty	Infectious disease
ICD-10	B02.2 (ILDS B02.270), G53.0
ICD-9-CM	053.11
DiseasesDB	11176
MedlinePlus	001647
eMedicine	neuro/420
MeSH	D016697