Anatomy & Histology · patient case question
Where does the virus remain latent in this patient?
Patient case: Rash in the ear (Ramsay Hunt syndrome)
Scenario: A patient with a RASH IN THE EAR. (The case does not name the condition — it is Ramsay Hunt syndrome.)
Show answer and explanation
Correct answer: A. Geniculate ganglion
- A. Correct. Ramsay Hunt syndrome — also called herpes zoster oticus or GENICULATE GANGLION herpes zoster — is reactivation of VZV in the GENICULATE GANGLION of the FACIAL NERVE (CN VII), within the facial canal of the petrous temporal bone. James Ramsay Hunt's original 1907 paper was titled 'On herpetic inflammations of the geniculate ganglion'.
- B. The pterygopalatine ganglion is a parasympathetic ganglion relaying CN VII fibres to the lacrimal gland and nasal/palatal mucosa.
- C. The otic ganglion is a PARASYMPATHETIC ganglion relaying CN IX fibres to the parotid gland; it is not a site of viral latency in this syndrome.
- D. The trigeminal (Gasserian/semilunar) ganglion is where HSV-1 and VZV lie latent for lesions in the TRIGEMINAL distribution — recurrent herpes labialis and trigeminal zoster. It is not the site for Ramsay Hunt syndrome.
Note: ⚠️ SOURCE ERROR CORRECTED. That is incorrect — Ramsay Hunt syndrome is defined by VZV reactivation in the GENICULATE ganglion of CN VII (verified against StatPearls, Medscape and multiple case-series reviews). If you see the trigeminal ganglion offered for a RAMSAY HUNT stem, it is the distractor.
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