Canadian Journal of Infectious Diseases and Medical Microbiology

Tommy L. H. Chan ¹, Ana M. Cartagena ¹, Anne Marie Bombassaro ², Seyed M. Hosseini-Moghaddam ³

Affiliations
1 Department of Clinical Neurological Sciences, London Health Sciences Centre (LHSC), London, ON, CA
2 Pharmacy Services, London Health Sciences Centre (LHSC) and Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, CA
3 Division of Infectious Diseases, Department of Medicine, London Health Sciences Centre (LHSC), London, ON, CA

Abstract

Ramsay Hunt syndrome associated with varicella zoster virus reactivation affecting the central nervous system is rare. We describe a 55-year-old diabetic female who presented with gait ataxia, right peripheral facial palsy, and painful vesicular lesions involving her right ear. Later, she developed dysmetria, fluctuating diplopia, and dysarthria. Varicella zoster virus was detected in the cerebrospinal fluid by polymerase chain reaction. She was diagnosed with Ramsay Hunt syndrome associated with spread to the central nervous system. Her facial palsy completely resolved within 48 hours of treatment with intravenous acyclovir 10mg/kg every 8 hours. However, cerebellar symptoms did not improve until a tapering course of steroid therapy was initiated.

Full Text