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Clinical investigation of Ramsay–Hunt syndrome with glossopharyngeal and vagal nerve involvement 拉姆齐-亨特综合征伴舌咽神经和迷走神经受累的临床研究

Edorium Journal of Neurology Pub Date : 2024-05-16 DOI: 10.5348/100019n06ns2024cr

Nobuko Shiraiwa, Akira Tamaoka, Norio Ohkoshi

{"title":"Clinical investigation of Ramsay–Hunt syndrome with glossopharyngeal and vagal nerve involvement","authors":"Nobuko Shiraiwa, Akira Tamaoka, Norio Ohkoshi","doi":"10.5348/100019n06ns2024cr","DOIUrl":"https://doi.org/10.5348/100019n06ns2024cr","url":null,"abstract":"\u0000 Introduction: Ramsay–Hunt syndrome is a peripheral facial nerve palsy accompanied by an erythematous vesicular rash in the ear (zoster oticus). Although involvement of the facial and vestibulocochlear nerves is typical in Ramsay–Hunt syndrome, multiple cranial neuropathies are rare, and are often associated with poorer prognosis and systemic complications. Here, we evaluated the clinical course of a rare case of Ramsay–Hunt syndrome associated with glossopharyngeal and vagal nerve disorders.\u0000\u0000 Case Report: A 75-year-old man presented with right facial paralysis, hoarseness, and dysphagia, leading to the diagnosis of Ramsay–Hunt syndrome with glossopharyngeal and vagal nerve disorders. The time between onset and initiation of antiviral drug administration was six days. Five years earlier, the patient had developed deafness on the same side along with dizziness. Facial paralysis and dysphagia improved nine months after onset; however, deafness, dizziness, and hoarseness persisted. The possibility of vestibulocochlear nerve palsy due to Zoster sine herpete was therefore considered.\u0000\u0000 Conclusion: Ramsay–Hunt syndrome with multiple cranial neuropathies is rare and is usually associated with a poorer prognosis. In this case, facial paralysis and dysphagia improved nine months after onset;however, deafness, dizziness, and hoarseness persisted. Therefore, attention must be paid to unilateral cranial nerve disorders, including Zoster sine herpete, during the assessment process.\u0000","PeriodicalId":517469,"journal":{"name":"Edorium Journal of Neurology","volume":"36 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140969741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anti-NMDA antibody autoimmune encephalitis post-HSV encephalitis: A rare case report HSV脑炎后抗NMDA抗体自身免疫性脑炎：罕见病例报告

Edorium Journal of Neurology Pub Date : 2024-03-13 DOI: 10.5348/100018n06ns2024cr

Neelam Sahu, Pushpendra Nath Renjen, Avinash Goswami, Shams Kanuga, Nidhi Goyal

{"title":"Anti-NMDA antibody autoimmune encephalitis post-HSV encephalitis: A rare case report","authors":"Neelam Sahu, Pushpendra Nath Renjen, Avinash Goswami, Shams Kanuga, Nidhi Goyal","doi":"10.5348/100018n06ns2024cr","DOIUrl":"https://doi.org/10.5348/100018n06ns2024cr","url":null,"abstract":"\u0000 Introduction: Autoimmune encephalitis is a group of neuropsychiatric disorder in which antibodies interact directly to their target antigen and produce neuronal dysfunction. Generally herpes simplex encephalitis is a monophasic illness although in few patients neurological worsening can develop some weeks later. This worsening is generally due to autoimmune encephalitis after herpes simplex encephalitis (AEaHSE).\u0000\u0000 Case Report: We report an interesting case report of 67 years old female patient who initially was diagnosed to have herpes simplex virus (HSV) encephalitis, showed improvement in her clinical status followed subsequently by deterioration in cognitive status. Anti-N-methyl-D-aspartate (NMDA) antibody was positive in cerebrospinal fluid (CSF) and serum. The patient was managed with intravenous immunoglobulin (IVIG) and subsequently showed improvement in her clinical state.\u0000\u0000 Conclusion: The discovery and clinical application of anti-NMDA receptor antibodies has helped to define the mechanism behind immune-based relapse of herpes simplex virus encephalitis (HSVE). This case illustrates the usefulness of testing for anti-NMDA receptor antibodies following worsening few weeks after treatment of herpes simplex encephalitis.\u0000","PeriodicalId":517469,"journal":{"name":"Edorium Journal of Neurology","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140284588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0