A 45-year-old woman presents with right-sided facial weakness, ear pain, and grouped vesicles on the concha and external auditory canal. Taste sensation over the anterior two-thirds of the tongue is diminished on the same side. Which structure is most likely involved by the causative virus?

• A Geniculate ganglion ✓
• B Gasserian ganglion
• C Nodose ganglion
• D Spiral ganglion

Explanation

Ramsay Hunt syndrome (herpes zoster oticus) results from reactivation of latent varicella-zoster virus in the geniculate ganglion of the facial nerve, producing ipsilateral facial palsy, auricular vesicles, ear pain, and often loss of taste over the anterior tongue with hyperacusis. The gasserian (trigeminal) ganglion reactivation gives dermatomal facial vesicles without facial palsy, which is the key distinction from this presentation.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.