Ramsay Hunt syndrome (RHS) refers to the association of unilateral peripheral facial nerve palsy and herpes zoster infection of the ear (herpes zoster oticus), with or without hearing loss.1 Involvement of additional cranial nerves is a phenomenon that has been recognized since the original clinical description but has received relatively little attention.2,3 We report a case of a patient with the clinical diagnosis of RHS presenting with multiple cranial neuropathies in whom a magnetic resonance imaging study of the brain demonstrated evidence of petrosal inflammation, a finding previously unsuspected in a condition known to spread through interneural connections.
Espay AJ, Bull RL. Petrositis in Ramsay Hunt Syndrome With Multiple Cranial Neuropathies. Arch Neurol. 2005;62(11):1774-1775. doi:10.1001/archneur.62.11.1774