Complete Ramsay Hunt Syndrome: a rare case

Background: Ramsay Hunt syndrome or herpes zoster oticus is a disorder caused by the reactivation of the varicella zoster virus in the geniculate ganglion, a bundle of nerve cells in the facial nerve. Symptoms include acute facial nerve palsy, otalgia, loss of taste in the anterior 2/3 of the tongue, dry mouth and eyes, and erythematous vesicular rash in the ear canal, tongue and / or palate. Objectives and Methods: Describe the case of a male patient, 26 years old, with complete Ramsay Hunt syndrome, reporting pain in the right ear with tinnitus, difficult to close his right eye, odynophagia and pain in the anterior 2/3 of the tongue at right side. Results: On examination, the presence of vesicles with erythema was observed in the region of the right external auditory canal and the ear, as well as on the right palate and tongue. Upon inspection, he had peripheral facial paralysis on the right, associated with loss of taste in the anterior 2/3 of the tongue. The patient was treated with antiviral and corticosteroids, followed for 3 months, obtaining partial recovery from facial paralysis. The anatomy of the facial nerve and its pathophysiology due to the involvement of herpes zoster will be discussed. Conclusion: Ramsay Hunt syndrome is often described as the presence of peripheral facial paralysis and vesicles in the auditory canal and the ear. However, this rare case presented the complete condition with the presence of vesicles on the palate and the tongue.