| Ramsay Hunt Syndrome during the Treatment of Zoster Sine Herpete. |
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Byung Seop Shin, Woo Seok Sim, Yong Chul Kim |
1Pain Management Center of Samsung Seoul Hospital, Korea. yongchul@smc.samsung.co.kr
2Department of Anesthesiology, SungKyunKwan University School of Medicine, Seoul, Korea. |
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| Abstract |
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Ramsay Hunt syndrome (RHS) might cause serious complications, such as facial paralysis and hearing loss if diagnosis and treatments are delayed. Early diagnosis is therefore very important to avoid such serious complications. We report a case of RHS that was occurred during the treatment of postherpetic neuralgia resulted from zoster sine herpete. The patient showed severe segmental intercostal neuralgia at the right 11 and 12th thoracic level. There were no history of the trauma, operation and skin rash and vesicle on the lesion site. Varicellar-zoster virus (VZV) IgG Antibody was positive but VZV IgM antibody was negative. Pain nature was severe sharp, electrical shock like pain, but no paresthesia and dysesthesia was not existed. About two month later, small painful vesicular eruptions were occurred around the ipsilateral auricle. At this time, VZV IgM antibody was positive. Acyclovir, prednisolone, fexofenadine were immediately prescribed. The patient relieved from RHS without any complications.
Clinician should be suspect the possibility of zoster sine herpete if the patient showed severe atypical chest wall pain. |
| Key Words:
Ramsay Hunt syndrome; zoster sine herpete |
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