title: Vestibular and cochlear neuritis in patients with Ramsay Hunt syndrome: a Gd-enhanced MRI study.
abstract: CONCLUSIONS
  It is suggested that vertigo in patients with Ramsay Hunt syndrome is mostly induced by superior vestibular neuritis consecutive to the reactivation of varicella-zoster virus (VZV) infection from the geniculate ganglion through the faciovestibular anastomosis. Refractory hearing loss in patients with Ramsay Hunt syndrome may be due to cochlear neuritis following the spread of VZV.
  
  
  OBJECTIVE
  An attempt was made to selectively identify vestibulocochlear nerves in the internal auditory canal (IAC) on gadolinium (Gd)-enhanced MRI in patients with Ramsay Hunt syndrome.
  
  
  METHODS
  Fourteen patients with Ramsay Hunt syndrome presenting with facial palsy, herpes zoster oticus, vertigo, and/or sensorineural hearing loss were scanned on 1.5 T MRI enhanced with Gd. Perpendicular section images of the IAC were reconstructed to identify the facial, superior, and inferior vestibular nerves and the cochlear nerves separately.
  
  
  RESULTS
  All except one of the patients with Ramsay Hunt syndrome with vertigo showed both canal paresis on the caloric test and Gd enhancement of the superior vestibular nerve in the IAC on MRI. Among 10 patients with hearing loss, 3 patients with severe to moderate sensorineural hearing loss showed Gd enhancement of the cochlear nerve in the IAC on MRI.
authors.affiliation: Department of Otolaryngology, Institute of Health Biosciences, University of Tokushima Graduate School, Japan.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Iwasaki
authors.forename: Naoki
authors.initials: N
authors.lastname: Toda
authors.forename: Mika
authors.initials: M
authors.lastname: Takahashi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Azuma
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Nakamura
authors.forename: Sho-Ichiro
authors.initials: S
authors.lastname: Takao
authors.forename: Masafumi
authors.initials: M
authors.lastname: Harada
authors.forename: Noriaki
authors.initials: N
authors.lastname: Takeda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005682:Gadolinium; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology; D016697:Herpes Zoster Oticus / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D014645:Herpesvirus 3, Human / Q000472:pathogenicity; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011856:Radiographic Image Enhancement; D018570:Risk Assessment; D012494:Sampling Studies; D014717:Vertigo / Q000175:diagnosis / Q000209:etiology; D020338:Vestibular Neuronitis / Q000175:diagnosis* / Q000209:etiology; D000160:Vestibulocochlear Nerve Diseases / Q000175:diagnosis* / Q000209:etiology
chemical_list: D005682:Gadolinium