• Investigative Magnetic Resonance Imaging
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• v.25 no.3
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• pp.197-200
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• 2021

Ramsay Hunt syndrome (RHS) is a disease caused by varicella-zoster virus (VZV) infection that can be diagnosed through clinical symptoms with or without imaging evaluations. The typical features of RHS on imaging evaluation include signal changes and enhancement in the internal auditory canal (IAC) nerves, and the labyrinthine segment of cranial nerve VII (CN VII) and cranial nerve VIII (CN VIII). In some patients, inner ear structure (cochlear and vestibular apparatus) is involved in RHS. Neurologic complications, such as encephalitis and meningitis, are rare in RHS, but are known to occur. Therefore, magnetic resonance imaging (MRI) is necessary to detect both abnormal signal intensity in the IAC, CN VII, CN VIII, inner and ear structure, and CNS complications. We report an RHS patient with CN VII, VIII, and leptomeningeal enhancement within the cerebellar folia on 10-min delayed, contrast-enhanced (CE), three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) imaging.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.31 no.4
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• pp.42-64
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• 2018

Objectives : The purpose of this study was to investigate the non-surgical treatment of peripheral facial paralysis sequelae such as bell's palsy and Ramsay-hunt syndrome during last 10 years. Methods : We searched articles in the RISS, MEDLINE, CAJ from January, 2008 to June, 2018. Articles on the non-surgical treatment of bell's palsy and Ramsay-hunt syndrome sequelae were included. We extracted data about treatments, characteristics of intervention, outcomes from the included studies and classified in to 4 categories such as case studies, RCTs, nRCTs, literature reviews. Results : 132 potentially relevant studies were identified, of which 60 studies met our inclusion criteria. Of 60 included studies, 30 were case reports, 22 were RCTs, 4 were nRCTs, and 4 were reviews. China (81.8%) were the most common by country, bell's palsy(81.7%) by disease, and case reports(50%) by study type were the most common. Symptoms were lagophthalmos, asymmetry, contracture, spasm, dacryorrhea, synkinesis, paresthesia, crocodile tears mostly in the order of frequency, and these symptoms occurred at least one month after the onset of symptoms. The most common method of treatment was acupuncture, which was used in 49 studies. As the evaluation variables, the effective rate was the highest in 25, House-Brakmann grading system in 17, and Sunnybrook facial grading system in 7. In 95% of the studies, after-treatment was reported to be cured, but objectivity is low. Conclusions : This study suggests that Korean medicine such as acupuncture can play a valid role in the non-surgical treatment of peripheral facial paralysis sequelae. In the future, a systematic and well-designed clinical study is needed for treatment of peripheral facial paralysis sequelae.

• Korean Journal of Bronchoesophagology
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• v.5 no.2
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• pp.222-230
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• 1999

Varicella-zoster virus(VZV) becomes latent in the sensory ganglia after primary infection and emerges from latency to cause zoster in adults. After primary infection, VZV remains latent in the dorsal spinal ganglia. The mechanisms responsible for its reactivation and the clinical entity of herpes zoster are poorly understood. Reactivation of VZV is commonly known to manifest as Ramsay Hunt syndrome which is one of the VZV-associated neurologic diseases with facial paralysis, ear pain, and a characteristic herpetic auricular rash. It is now known that lesions of this syndrome can affect all cranial nerves. Central, cervical and peripheral effects of this syndrome is polyneuropathic in nature. VZV usually involves the 5th and 7th cranial nerves and less commonly the lower cranial nerves such as 9th and 10th. We report a treated case of healthy 40 years old male with VZV infection of the 5th, 9th and 10th cranial nerves. The patient typically showed herpetic vesicles in the auricle and temporal bone area without facial paralysis.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.22 no.1
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• pp.148-156
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• 2009

Objectives : Facial palsy is not uncommon disease and most patients with facial palsy are peripheral type, as in Bell' s palsy. In western medicine, oral steroid is the mainstay of the treatment. Recently, oriental-western treatment became one of the alternative modality for the treatment of the facial palsy. However, the treatment result and the degree of patient' s satisfaction were not evaluated. In this study, we tried to characterize the clinical characteristics, short-term recovery rate and degree of patient' s satisfaction after oriental-western medicine treatment on facial palsy of peripheral type. Methods : Between May 2008 and December 2008, we examined 16 patients who presented with facial palsy of peripheral type in Dongguk University Medical Center. Clinical characteristics and recovery rate was analyzed by retrospective chart review. The degree of patient' s satisfaction was measured by 5 point scale. Results : The causes of facial palsy were Bell' s palsy (87.5%) and the Ramsay-Hunt syndrome (12.5%). The highest age groups of facial palsy were 6th and 7th decades. Most frequent accompanying symptom was postauricular pain. After oriental-western medicine treatment, 10 patients (62.5%) showed recovery of facial palsy better than House-Brackmann grade 2. 11 patients (68.8%) were satisfied with the oriental-western medicine treatment. Conclusions : Considering the degree of patient' s satisfaction and treatment result, we believe that oriental-western treatment could be safe and reliable protocol for the treatment of facial nerve palsy of peripheral type.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.14 no.1
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• pp.76-86
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• 2001

Herpes zoster oticus which is called Ramsay Hunt syndrome, geniculate ganglion herpes and otic herpes, is characterized by a viral prodrome with otalgia, vesicular eruptions, facial paralysis, hearing disturbance, tinnitus, vertigo and other symtoms. Among cranial nerves, trigeminal and facial nerves are the most commonly affected in patients with herpes zoster oticus, but on rare occasions 8th, 9th, 10th, 11th, 12th cranial nerves and even the upper cervical nerve are influenced as well.. In general, it has poor prognosis compared with Bell's palsy, leaving permanent facial nerve dysfunction. We report a case of Herpes zoster oticus, which was fully recovered by acupuncture and herbal medication within 12 days. We used $FEMA^{11)}$ and House-Brackmann's grading system to assess the degree of paralysis in each part of face.

• Journal of Pharmacopuncture
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• v.4 no.2
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• pp.73-86
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• 2001

Objective : These case study were made to evaluate and observe the treatment for the Herpes-Zoster through the korean oriental medicine. Method : Clinical observation and analysis about 4 cases of Herpes-zoster including the Ramsay's-hunt syndrome had been done the patients of the Sang-Ji Oriental Medicine Hospital. These cases were mainly treated with oriental medicine using the Herb medication, Korean Bee-Venom therapy, Acupuncture and Electro-acupuncture therapy. Acupuncture technic was mainly used Sa-Am acupuncture(Four needle technique). Result : After treatment, all of cases were completely cured without any complication. Conclusion : Based on the clinical results, Korean Oriental Medicine is believed to be effective for treating Herpes-zoster, and further studies should be conducted to provide more valuable information.

• The Korean Journal of Pain
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• v.26 no.2
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• pp.195-198
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• 2013

Herpes zoster is a cutaneous infection that is characterized by an acute vesicobullous rash with ipsilateral one or two dermatomal distribution and painful allodynia, while predominantly being found in the elderly. Extensive cutaneous dissemination has been reported in immune-compromised patients, such as those who suffer from HIV infections, cancer, chemotherapy, and corticosteroid therapy patients. However, we report a case of disseminated herpes zoster infection in an immuno-competent elderly individual.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.33 no.1
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• pp.56-74
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• 2020

Objectives : The purpose of this study is to analyze the trend of Korean medical treatments on acute stage of herpes zoster. Methods : Domestic databases(OASIS, KTKP, RISS, NDSL, KISS) were used to search case study papers related to the acute herpes zoster. Total 33 studies were selected and analyzed. Results : According to clinical type, Ramsay Hunt syndrome was the most frequent type, followed by herpes zoster genralisatus, facial herpes zoster. Manual acupuncture was the most frequently used treatment modalities, followed by Korean herbal medicine. LI4(合谷), LR3(太衝), ST36(足三里), GB20(風池) were the major acupoints used for the treatment of acute herpes zoster. Yongdamsagan-tang(龍膽瀉肝湯) was the most frequently used prescription followed by Ligigeopoong-san(理氣祛風散). As principal herb, Gentianae Scabrae Radix et Rhizoma(龍膽) and Bupleuri Radix(柴胡) were the most frequently used herbs followed by Alismatis Rhizoma(澤瀉). Conclusions : Though several limits remains, this is the first study to analyze the trends of Korean medicine treatment for the acute stage of herpes zoster, it may helpful for the clinical practitioner.

• Journal of Audiology & Otology
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• v.25 no.2
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• pp.89-97
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• 2021

Background and Objectives: Bilateral sequential vestibular neuritis (BSVN) is a rare condition in which an inflammation or an ischemic damage of the vestibular nerve occurs bilaterally in a sequential pattern. We described four cases of BSVN. Subjects and Methods: Every patient underwent video-head impulse test during the first and the second episode of vestibular neuritis (VN), furthermore they have been studied with radiological imaging. Results: Contralateral VN occurred after a variable period from prior event. Vestibular function recovered from the first episode in one case. The other three patients developed contralateral VN. One case was due to a bilateral VN in association with a Ramsay-Hunt syndrome, in another patient clinical records strongly suggested an ischemic etiology, whereas in two cases aetiology remained uncertain. Two patients subsequently developed a benign paroxysmal positional vertigo involving the posterior canal on the side of the latest VN (Lindsay-Hemenway syndrome). Conclusions: Instrumental vestibular assessment represents a pivotal tool to confirm the diagnosis of VN and BSVN.

• Korean Journal of Audiology
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• v.25 no.2
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• pp.89-97
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• 2021

Background and Objectives: Bilateral sequential vestibular neuritis (BSVN) is a rare condition in which an inflammation or an ischemic damage of the vestibular nerve occurs bilaterally in a sequential pattern. We described four cases of BSVN. Subjects and Methods: Every patient underwent video-head impulse test during the first and the second episode of vestibular neuritis (VN), furthermore they have been studied with radiological imaging. Results: Contralateral VN occurred after a variable period from prior event. Vestibular function recovered from the first episode in one case. The other three patients developed contralateral VN. One case was due to a bilateral VN in association with a Ramsay-Hunt syndrome, in another patient clinical records strongly suggested an ischemic etiology, whereas in two cases aetiology remained uncertain. Two patients subsequently developed a benign paroxysmal positional vertigo involving the posterior canal on the side of the latest VN (Lindsay-Hemenway syndrome). Conclusions: Instrumental vestibular assessment represents a pivotal tool to confirm the diagnosis of VN and BSVN.