Ramsay Hunt syndrome (RHS) refers to the association of unilateral peripheral facial nerve palsy and herpes zoster infection of the ear (herpes zoster oticus), with or without hearing loss.1 Involvement of additional cranial nerves is a phenomenon that has been recognized since the original clinical description but has received relatively little attention.2- 3 We report a case of a patient with the clinical diagnosis of RHS presenting with multiple cranial neuropathies in whom a magnetic resonance imaging study of the brain demonstrated evidence of petrosal inflammation, a finding previously unsuspected in a condition known to spread through interneural connections.
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Initial examination findings in an 83-year-old woman. A, Well-circumscribed eythematous rash on the left ear. Dry exudate from vesicular lesions can be appreciated. B, Left facial weakness with Bell’s phenomenon (normal upward rolling of the ipsilateral eye when patient is asked to occlude the eyes).
The T2-weighted axial magnetic resonance images of the brain (obtained with a 1.5-T magnetic resonance unit; repetition time, 3500 milliseconds; echo time, 112 milliseconds) from pons (A) to medulla (D), showing spotty high signal in the air cells of the left mastoid process consistent with acute inflammation (arrowhead, A-D) and diffuse thickening with linear hyperintensity of the left external auditory canal (opposing arrows, D). The facial and vestibulocochlear nerves (arrows, B and C) can be seen entering the inflammatory petrous region. No enhancement on individual cranial nerves was elicited after gadolinium administration.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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