Immunological and Virological Aspects of Hunt's Syndrome Associated with Multiple Cranial Nerve Paralyses: A Case Report

Abstract

A patient with Hunt's syndrome had not only facial and vestibular nerve paralysis, but also glossopharyngeal, vagal and hypoglossal nerve paralysis. The patient was a 74-year-old fbmale who complained of right auricular pain, vertigo, hoarseness and right facial palsy. Physical examination revealed right auricular herpetic vesicles, peripheral facial palsy, paralysis of the soft palate, right laryngeal paralysis and deviation of the tongue. Hearing was also impaired. Vestibular examination showed right CP and left DP. A varicella-zoster virus(VZV)skin test reflecting cellmediated immunity was negative; a PPD skin test was positive. T and NK cells were decreased. VZV-antibody titers was remarkably high. These laboratory examination showed that humoral immunity was relatively normal but cellmediated immunity was depressed in Hunt's syndrome.