A patient with sudden-onset ipsilateral complete facial palsy, herpetic vesicles in the ear canal and concha, severe otalgia, and ipsilateral sensorineural hearing loss with vertigo is diagnosed with Ramsay Hunt syndrome. The causative organism is:
- A Varicella-zoster virus (VZV) reactivating in the geniculate ganglion ✓
- B Herpes simplex virus type 1
- C Cytomegalovirus
- D Epstein-Barr virus
Correct answer: A. Varicella-zoster virus (VZV) reactivating in the geniculate ganglion
Explanation
Ramsay Hunt syndrome (herpes zoster oticus) is caused by reactivation of latent varicella-zoster virus in the geniculate ganglion of the facial nerve. It presents with otalgia, auricular vesicles (in the distribution of the sensory branch of CN VII), ipsilateral facial paralysis, and may include SNHL and vertigo when the vestibulocochlear nerve is involved. It carries a worse prognosis than Bell's palsy for facial nerve recovery. Treatment is acyclovir and prednisolone.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.