title: Acyclovir responsive brain stem disease after the Ramsay Hunt syndrome.
abstract: We report an immunocompetent patient with the Ramsay Hunt syndrome (RHS) followed days later by brainstem disease. Extensive virological studies proved that varicella zoster virus (VZV) was the causative agent. Treatment with intravenous acyclovir resulted in prompt resolution of all neurological deficits except peripheral facial palsy. This case demonstrates that after geniculate zoster, brainstem disease may develop even in an immunocompetent individual and effective antiviral therapy can be curative.
authors.affiliation: Department of Neurology, University of Washington, Box 356465, Seattle, WA 98195, USA.
authors.forename: Shuching
authors.initials: S
authors.lastname: Hu
authors.forename: Melanie
authors.initials: M
authors.lastname: Walker
authors.forename: Todd
authors.initials: T
authors.lastname: Czartoski
authors.forename: Alan
authors.initials: A
authors.lastname: Cheng
authors.forename: Bagher
authors.initials: B
authors.lastname: Forghani
authors.forename: Donald H
authors.initials: DH
authors.lastname: Gilden
authors.forename: Gwenn A
authors.initials: GA
authors.lastname: Garden
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D020330:Bell Palsy / Q000188:drug therapy / Q000821:virology; D001933:Brain Stem / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology / Q000821:virology; D005158:Facial Paralysis / Q000188:drug therapy / Q000821:virology; D005260:Female; D005682:Gadolinium / Q000378:metabolism; D003639:Hearing Loss, Sudden / Q000188:drug therapy / Q000821:virology; D014645:Herpesvirus 3, Human / Q000187:drug effects / Q000302:isolation & purification*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D002527:Myoclonic Cerebellar Dyssynergia / Q000150:complications* / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology / Q000821:virology; D009759:Nystagmus, Pathologic / Q000188:drug therapy / Q000821:virology; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D005682:Gadolinium; D000212:Acyclovir