Abstract
We report a case of Ramsay Hunt syndrome with involvement of the VI-X cranial nerves and meningitis. The patient was a 68-year-old woman with complaints of left hearing impairment, left facial palsy, dizziness, sore throat, hoarseness and double vision. Physical examination revealed left vocal cord paralysis. On examination of hearing and vestibular function, left sensorineural hearing total deafness and left canal palsy were found. OKP showed brain stem encephalitis. Cerebrospinal fluid examination revealed a remarkable increase in cell count, thus the patient was diagnosed with zoster virus meningitis. A steroid hormone and acyclovir were administered intravenously. Three months after the first examimation, disturbance of the VI and VII cranial nerves abated completely. The disturbance of the VIII and X cranial nerves, however, did not respond to the treatment at all.
It is important to consider the possibility of brain stem encephalitis in cranial polyneuropathy. We consider that cranial polyneuropathy may result from brain stem encephalitis, and brain stem encephalitis may result from meningitis.
