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Pathology · single question

A 63-year-old male (psoriasis, takes cyclosporine) has a crusting vesicular rash on the RIGHT side of his face NOT crossing the midline, with limited facial muscle mobility and tinnitus. Which syndrome?

  1. Ramsay Hunt syndrome
  2. Melkersson-Rosenthal syndrome
  3. Guillain-Barré syndrome
  4. Trigeminal neuralgia
Show answer and explanation

Correct answer: A. Ramsay Hunt syndrome

  • A. Correct. Ramsay Hunt syndrome = VZV reactivation in the geniculate ganglion of CN VII. Classic: facial palsy + vesicular rash not crossing midline + ipsilateral hearing loss/tinnitus.
  • B. Melkersson-Rosenthal shows facial swelling, recurrent facial palsy, fissured tongue — not vesicular rash.
  • C. Guillain-Barré is bilateral ascending polyneuropathy — not unilateral vesicular rash with tinnitus.
  • D. Trigeminal neuralgia causes lancinating facial pain but no vesicular rash or tinnitus.

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