Ramsay Hunt syndrome with multicranial nerve involvement.
CONCLUSIONS
Ramsay Hunt syndrome (RHS) with multiple involvement of cranial nerves is more severe and intractable than RHS without such involvement.


OBJECTIVE
Typically, RHS involves VII and VIII nerves and unilaterally, and RHS accompanied by multiple cranial neuropathy is very rare. We describe 11 patients who developed RHS with multicranial nerve involvement and we analyzed their clinical characteristics and compared them with those of patients with RHS not accompanied by multiple cranial neuropathy.


METHODS
During the period 1995-2009, we treated 339 patients with RHS; of these, 11 patients had concurrent multiple cranial neuropathy. We assessed the clinical characteristics of RHS patients with and without multiple cranial neuropathy.


RESULTS
The mean age of the 11 patients with multiple cranial neuropathy (6 men, 5 women) was 49.2 ± 19.4 years, although 7 were aged 50 years or older. Eight patients had right-sided and three had left-sided facial paralysis. The initial degree of facial paralysis was House-Brackmann (HB) grade IV in four patients (36.4%) and HB grade V in seven (63.6%). Six patients showed improvement in symptoms, whereas five (45.6%) showed no improvement. The recovery rates from facial paralysis in patients with and without multiple cranial neuropathy were 54.5% and 82.9%, respectively, and the complete recovery rates were 27.3% and 67.7%, respectively.
Department of Otolaryngology, College of Medicine, EulJi University, Seoul, Korea.
Hyun Joon
HJ
Shim
Hoon
H
Jung
Dong Choon
DC
Park
Jong Ha
JH
Lee
Seung Geun
SG
Yeo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D003389:Cranial Nerve Diseases / Q000175:diagnosis / Q000628:therapy* / Q000821:virology*; D005158:Facial Paralysis / Q000175:diagnosis / Q000628:therapy / Q000821:virology; D005260:Female; D016697:Herpes Zoster Oticus / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult