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Pathology · single question

Same case (Ramsay Hunt syndrome). Which nerve is the PRIMARY nerve affected?

  1. Hypoglossal nerve (CN XII)
  2. Vestibulocochlear nerve (CN VIII)
  3. Facial nerve (CN VII)
  4. Trigeminal nerve (CN V)
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Correct answer: B. Vestibulocochlear nerve (CN VIII)

  • A. Incorrect. CN V is for facial sensation; Ramsay Hunt involves VZV in the geniculate ganglion of CN VII.
  • B. Correct. The facial nerve (CN VII) is the PRIMARY nerve affected. VZV reactivates in its geniculate ganglion, causing facial palsy.
  • C. Incorrect. CN XII controls tongue movements and is not affected.
  • D. Incorrect. CN VIII is ALSO affected (tinnitus/hearing loss) but CN VII is the primary nerve.

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