Sympathetic contralateral vestibulopathy after unilateral zoster oticus.
A unique case of initially right sided varicella zoster induced Ramsay-Hunt syndrome with complete vestibular loss is reported. The patient subsequently developed deficits of the left vestibule 5 months later. An autoimmune pathogenesis of the left vestibular failure rather than bilateral varicella zoster infection was suggested by the following data: (1) no evidence of vesicular eruptions on the left auricle and the virtual absence of antiviral antibodies after onset of bilateral vestibulopathy; (2) prompt response of the left vestibule to immunosuppressive therapy with corticosteroids; and (3) presence of atypical nervous tissue specific autoantibodies against a 45 kDa protein.
Schulz
P
P
Department of Neurology, Ludwig-Maximilians University Munich, Klinikum Grobetahadern, Marchioninistr. 23, D-81377 Munich, Germany. pschulz@nefo.med.uni-muenchen.de
Arbusow
V
V
Strupp
M
M
Dieterich
M
M
Sautier
W
W
Brandt
T
T
D000328:Adult; D015153:Blotting, Western; D004584:Electronystagmography; D005260:Female; D005455:Fluorescent Antibody Technique; D007839:Functional Laterality / Q000502:physiology; D016697:Herpes Zoster Oticus / Q000150:complications*; D006801:Humans; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D015837:Vestibular Diseases / Q000150:complications / Q000503:physiopathology*