title: Acute Facial Nerve Palsy With Ipsilateral Soft Palate Ulcers.
abstract: Ramsay-Hunt syndrome (RHS) is a rare complication of herpes zoster in which reactivation of latent varicella zoster virus (VZV) infection occurs in the geniculate ganglion. Major clinical findings are peripheral facial nerve palsy accompanied by ipsilateral ear pain and erythematous vesicular rash on the external ear (herpes zoster oticus) and in the mouth. Thus, diagnosis of RHS is usually clinical. However, auricular herpetic eruption is not always present, making diagnosis more difficult. This report describes a case of RHS with left facial palsy without skin lesions in 60-year-old woman. Multiple ulcers were found on her left soft palate. Polymerase chain reaction analysis on oral mucosa biopsy samples and serologic assays allowed the identification of VZV as the causal agent. Knowledge of the anatomy of the facial nerve is important for oral and maxillofacial surgeons when dealing with patients with RHS, especially in unusual and clinically misleading forms of this syndrome.
authors.affiliation: Associate Professor, Pôle d'Odontologie, Hôpital Maison Blanche, Centre Hospitalier Universitaire, Reims; Laboratoire EA 4691 Biomatériaux et Inflammation en Site Osseux, Université Reims Champagne-Ardennes, Reims, France.
authors.forename: Cédric
authors.initials: C
authors.lastname: Mauprivez
authors.affiliation: Resident, Pôle d'Odontologie, Hôpital Maison Blanche, Centre Hospitalier Universitaire, Reims, France.
authors.forename: Clément
authors.initials: C
authors.lastname: Comte
authors.affiliation: Professor, Service d'Oto-rhino-laryngologie et de chirurgie de la face et du cou, Hôpital Robert-Debré, Centre Hospitalier Universitaire, Reims, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Labrousse
authors.affiliation: Associate Professor, AP-HP, Service de chirurgie maxillo-faciale, Hôpital Universitaire Pitié-Salpêtrière, Paris; Université Pierre-et-Marie-Curie, Paris, France. Electronic address: roman.khonsari@aphp.fr.
authors.forename: Roman H
authors.initials: RH
authors.lastname: Khonsari
mesh_terms: D000208:Acute Disease; D000212:Acyclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D014645:Herpesvirus 3, Human / Q000302:isolation & purification*; D006801:Humans; D008875:Middle Aged; D019226:Oral Ulcer / Q000188:drug therapy / Q000821:virology*; D010160:Palate, Soft; D020734:Parkinsonian Disorders / Q000188:drug therapy / Q000821:virology*; D011239:Prednisolone / Q000627:therapeutic use; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D005938:Glucocorticoids; D011239:Prednisolone; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir