Pathology · single question
RAMSAY HUNT SYNDROME CASE: A patient presents with Bell's palsy (facial nerve paralysis) AND an ipsilateral vesicular rash in the ear canal. Which virus is responsible?
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Correct answer: B. Varicella-Zoster Virus (VZV)
Ramsay Hunt Syndrome (Herpes Zoster Oticus) is caused by reactivation of Varicella-Zoster Virus (VZV) in the geniculate ganglion of CN VII (facial nerve). It presents with ipsilateral facial nerve palsy + painful vesicular eruption in the ear canal (auricle), and may include hearing loss, tinnitus, and vertigo. It differs from Bell's palsy in that it has a known viral etiology (VZV) and generally has a worse prognosis.
- A. Incorrect. HSV-1 causes recurrent herpes labialis and herpetic gingivostomatitis, not the ear rash + facial paralysis combination of Ramsay Hunt.
- B. CORRECT. VZV reactivation in the geniculate ganglion causes Ramsay Hunt Syndrome — the combination of CN VII palsy and ipsilateral otic vesicular rash is pathognomonic.
- C. Incorrect. EBV causes infectious mononucleosis and is associated with Burkitt's lymphoma and nasopharyngeal carcinoma — not Ramsay Hunt syndrome.
- D. Incorrect. CMV causes mononucleosis-like illness in immunocompetent patients and serious systemic disease in immunocompromised patients — not Ramsay Hunt.