title: Herpetic cranial polyneuritis mimicking brain stem infarction-an atypical presentation of Ramsay Hunt syndrome.
abstract: An elderly man presented with severe right ear pain and discharge, hoarseness and dysphagia causing significant involuntary weight loss. Extensive investigations by varied specialties only highlighted right vocal cord palsy and right parotid lymphadenitis. Reassessment on transfer to a rehabilitation ward noted clinically subtle right Ramsay Hunt syndrome with multiple lower cranial nerve involvement. We illustrate a case of varicella zoster virus cranial polyneuritis with bulbar symptoms mimicking bulbar stroke, requiring percutaneous endoscopic gastrostomy feeds, with significant clinical and radiological recovery over 1 year.
authors.affiliation: Department of Geriatric Medicine, Fremantle Hospital, Perth, Western Australia, Australia.
authors.forename: Sneha
authors.initials: S
authors.lastname: Bharadwaj
authors.affiliation: Fiona Stanley Hospital, Perth, Western Australia, Australia.
authors.forename: Andrew Campbell
authors.identifier: http://0000-0001-5671-2259
authors.initials: AC
authors.lastname: Moffat
authors.affiliation: Department of Medical Imaging, Fiona Stanley Hospital, Perth, Western Australia, Australia.
authors.forename: Brad
authors.identifier: http://orcid.org/0000-0001-7466-8044
authors.initials: B
authors.lastname: Wood
authors.affiliation: School of Anatomy, Physiology and Human Biology, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Avinash
authors.initials: A
authors.lastname: Bharadwaj
mesh_terms: D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging; D020526:Brain Stem Infarctions / Q000150:complications; D003680:Deglutition Disorders / Q000209:etiology; D003937:Diagnosis, Differential; D006562:Herpes Zoster / Q000097:blood; D016697:Herpes Zoster Oticus / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D009443:Neuritis / Q000175:diagnosis / Q000209:etiology*; D014826:Vocal Cord Paralysis / Q000209:etiology*