Herpes Zoster Oticus Park SY A B C Fig. 1. Variable extent of auricular vesicular eruptions of three different cases of typical Ramsay Hunt syndrome.

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online ML Comm Clinical Review Korean J Otorhinolaryngol-Head Neck Surg 2014;57:78-83 / pissn 2092-5859 / eissn 2092-6529 http://dx.doi.org/10.3342/kjorl-hns.2014.57.2.78 Herpes Zoster Oticus Sang Yoo Park Department of Otolaryngology-Head and Neck Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea 이성대상포진 박상유 연세대학교원주의과대학이비인후과학교실 Received March 26, 2013 Accepted June 18, 2013 Address for correspondence Sang Yoo Park, MD, PhD Department of Otolaryngology- Head and Neck Surgery, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 220-701, Korea Tel +82-33-741-0642 Fax +82-33-732-8287 E-mail sangyoo3@yonsei.ac.kr Herpes zoster oticus, traditionally known as Ramsay Hunt syndrome, is nowadays described also as acute peripheral facial neuropathy by varicella zoster virus infection. Besides facial palsy, auricular vesicular eruptions accompanied by neuralgic pain, adjacent cranial nerve structures are involved and various audiovestibular symptoms are frequently combined. Early proper treatment strategies are required to get the favorable outcome and reduce the morbidity of neurocranial deficits of this syndrome. Korean J Otorhinolaryngol-Head Neck Surg 2014;57:78-83 Key WordsZZHerpes zoster oticus ㆍ Ramsay Hunt syndrome. 서론 - - - 78 Copyright 2014 Korean Society of Otorhinolaryngology-Head and Neck Surgery

Herpes Zoster Oticus Park SY A B C Fig. 1. Variable extent of auricular vesicular eruptions of three different cases of typical Ramsay Hunt syndrome. Localized to cymba concha (A). Appeared all over the auricle (B). Massive spread into face (C). 임상증상의다양성 www.jkorl.org 79

Korean J Otorhinolaryngol-Head Neck Surg 2014;57:78-83 청각및전정신경의증상 - - 소아기의이성대상포진 진단 in situ 80

Herpes Zoster Oticus Park SY 치료 - A Fig. 2. 33-year-old female patient with Rt Ramsay Hunt syndrome. On the gadolinium enhanced T1 weighted axial and coronal images, the intracanalicular and labyrinthine segment of Rt facial nerve enhanced abnormally, and its ganglion and proximal tympanic segment enhanced asymmetrically compared to the opposite side. Axial image (A). Coronal image (B). B www.jkorl.org 81

Korean J Otorhinolaryngol-Head Neck Surg 2014;57:78-83 예후 결 론 REFERENCES 1) Körner O. Über den Herpes zoster oticus. Munch Med Wochenschr 1904;1:6-10. 2) Hunt JR. On herpetic inflammations of the geniculate ganglion: a new syndrome and its complications. J Nerv Ment Dis 1907;34:73-96. 3) Hunt JR. The sensory system of the facial nerve and its symptomatology. J Nerv Ment Dis 1909;36:321-50. 4) Hunt JR. The symptom-complex of the acute posterior poliomyelitis of the geniculate, auditory, glossopharyngeal and pneumogastric ganglia. Arch Intern Med 1910;5:631-75. 5) Hunt JR. The role of the carotid arteries in the causation of vascular lesions of the brain, with remarks on certain special features of the symptomatology. Am J Med Sci 1914;147:704-13. 6) Hunt JR. Dyssynergia cerebellaris progressiva: a chronic progressive form of cerebellar tremor. Brain 1914;37(2):247-68. 7) Burke BL, Steele RW, Beard OW, Wood JS, Cain TD, Marmer DJ. Immune responses to varicella-zoster in the aged. Arch Intern Med 1982;142(2):291-3. 8) Ikeda M, Hiroshige K, Abiko Y, Onoda K. Impaired specific cellular immunity to the varicella-zoster virus in patients with herpes zoster oticus. J Laryngol Otol 1996;110(10):918-21. 9) Hu S, Walker M, Czartoski T, Cheng A, Forghani B, Gilden DH, et al. Acyclovir responsive brain stem disease after the Ramsay Hunt syndrome. J Neurol Sci 2004;217(1):111-3. 10) Alicandri-Ciufelli M, Aggazzotti-Cavazza E, Genovese E, Monzani D, Presutti L. Herpes zoster oticus: a clinical model for a transynaptic, reflex pathways, viral transmission hypotheses. Neurosci Res 2012; 74(1):7-9. 11) Gilden D, Cohrs RJ, Mahalingam R, Nagel MA. Varicella zoster virus vasculopathies: diverse clinical manifestations, laboratory features, pathogenesis, and treatment. Lancet Neurol 2009;8(8):731-40. 12) Aviel A, Marshak G. Ramsay Hunt syndrome: a cranial polyneuropathy. Am J Otolaryngol 1982;3(1):61-6. 82

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