A patient presents with right-sided lower motor neuron facial palsy and vesicular eruptions in the right external auditory canal and soft palate. The condition is Ramsay Hunt syndrome. The virus responsible and its site of latency are:

• A Herpes simplex virus type 1; trigeminal ganglion
• B Epstein-Barr virus; cervical dorsal root ganglia
• C Cytomegalovirus; spiral ganglion of the cochlea
• D Varicella-zoster virus; geniculate ganglion of the facial nerve ✓

Explanation

Ramsay Hunt syndrome (herpes zoster oticus) is caused by reactivation of varicella-zoster virus (VZV) latent in the geniculate ganglion of the facial nerve. Reactivation causes facial nerve palsy, otalgia, and vesicular eruptions in the distribution of the sensory branch of the facial nerve — the external auditory canal (Ramsay Hunt zone), auricle, and soft palate/tongue (via nervus intermedius). It is associated with worse prognosis than Bell's palsy; treatment is early antiviral therapy (acyclovir/valacyclovir) with corticosteroids.

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.