Anatomy & Histology · single question
Same case (Ramsay Hunt syndrome): Which of the following nerves is most likely to be affected?
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Correct answer: D. Facial
Ramsay Hunt syndrome is caused by reactivation of varicella-zoster virus in the geniculate ganglion of the facial nerve (CN VII). It presents with ipsilateral facial paralysis, ear pain, and vesicular rash. Although tinnitus and hearing changes may suggest CN VIII involvement, the PRIMARY nerve affected causing facial paralysis and vesicular rash is CN VII (facial nerve).
- A. INCORRECT. The vestibulocochlear nerve (CN VIII) may be secondarily affected (causing tinnitus/hearing loss), but the PRIMARY nerve responsible for the defining signs of Ramsay Hunt is CN VII.
- B. INCORRECT. The hypoglossal nerve (CN XII) provides motor innervation to the tongue. It is not involved in Ramsay Hunt syndrome.
- C. INCORRECT. The trigeminal nerve (CN V) mediates facial sensation. Ramsay Hunt does not primarily affect CN V.
- D. CORRECT. The facial nerve (CN VII) is the primary nerve affected in Ramsay Hunt syndrome. VZV reactivates in the geniculate ganglion of CN VII, causing ipsilateral facial palsy, ear pain, vesicular rash, and sometimes tinnitus from proximity to CN VIII.
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