Ramsay Hunt Syndrome with cranial polyneuropathy and aseptic meningoencephalitis: A case report

Ramsay Hunt Syndrome is characterized by paroxysmal ear pain, and vesicular rash around the ear with ipsilateral facial nerve palsy. It is due to the reactivation of the Varicella Zoster Virus (VZV) in the facial nerve ganglion. It is considered the second most common cause of peripheral facial nerve palsy. A 14-year-old immunocompetent boy presented with fever associated with vertigo, facial asymmetry and difficulty in swallowing. He had a few crusted lesions in his left ear pinna and ear canal on examination. A cranial nerve examination revealed a left-sided facial and palatal palsy. Cerebrospinal fluid (CSF) analysis was suggestive of a viral meningoencephalitis.This case highlights the importance of clinicians recognizing Ramsay Hunt syndrome amongst patients presenting with multiple cranial nerve involvement and amongst those with meningoencephalitis.