A Case of Ramsay Hunt Syndrome with Multiple Cranial Nerve Neuropathy

Ramsay Hunt syndrome (RHS) is characterized by facial nerve paralysis, herpetic vesicles around the ear, and pain; it is most frequently associated with VIII cranial nerve involvement, but on rare occasions, other cranial nerves are affected as well. We present the case of a 63-year-old woman of RHS with involvement of the V, VII, VIII, IX, X and XI cranial nerves. The patient was a 63-year-old woman with complaints of left hearing impairment, left facial palsy, dizziness, sore throat, hoarseness, and dysphagia. Physical examination revealed left vocal cord paralysis. Examination of hearing and vestibular functions revealed left sensorineural hearing loss and left canal paresis. The patient showed significant improvement after treatment with acyclovir and prednisolone. RHS should be recognized as polycranial neuritis characterized by damage of both sensory and motor nerves, including the facial nerve and the auditory-vestibular apparatus.