title: [Case of atypical Ramsay-Hunt syndrome who presented with severe vertigo and vomiting].
abstract: We herein present a case of 6-year-old female demonstrating atypical Ramsay-Hunt syndrome. She presented with an earache, severe vertigo, and vomiting at onset, and thereafter, herpes zoster oticus appeared. No facial nerve palsy was seen. She was vaccinated for varicella and had no past history of apparent varicella infection. The patient showed positive IgG and negative IgM serum antibodies for varicella-zoster virus (VZV). An analysis of VZV-DNA from the patient's ear lesion using alleric discrimination real-time PCR identified a wild-type strain of VZV. We diagnosed her to have atypical Ramsay-Hunt syndrome caused by reactivation of the VZV. Aciclovir and prednisolone were administered, and she recovered completely. This case indicates that Ramsay-Hunt syndrome could be caused by a VZV infection after vaccination, even though its frequency is low. Ramsay-Hunt syndrome may thus be considered as one of causes of sudden onset vertigo in children.
authors.affiliation: Department of Pediatrics, National Defense Medical College Hospital, Tokorozawa, Saitama. dr23026@ndmc.ac.jp
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsumoto
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage; D019433:Chickenpox Vaccine / Q000009:adverse effects; D002648:Child; D003937:Diagnosis, Differential; D004433:Earache / Q000209:etiology; D005260:Female; D016697:Herpes Zoster Oticus / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000821:virology; D014645:Herpesvirus 3, Human / Q000302:isolation & purification; D006801:Humans; D011239:Prednisolone / Q000008:administration & dosage; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014717:Vertigo / Q000209:etiology*; D014839:Vomiting / Q000209:etiology*
chemical_list: D019433:Chickenpox Vaccine; D011239:Prednisolone; D000212:Acyclovir