{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T23:20:12Z","timestamp":1768432812964,"version":"3.49.0"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>Ramsay Hunt syndrome (RHS) refers to a reactivation of the varicella-zoster virus in the distribution of the facial nerve, but it can involve other cranial nerves as well. In patients with polyneuropathy, the vestibulocochlear nerve is most involved after the facial nerve. The clinical manifestations and long-term vestibular outcomes in these patients remain unclear. This report aims to characterize the clinical course of this rare subset of RHS patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>This study is a retrospective case series. The study was conducted in a tertiary care institution. Patients with RHS polyneuropathy presenting with vestibular deficit were reviewed over a 30-year period. Case details including initial presentation, House-Brackmann grade, treatment regimen, vestibular examination and testing, MRI findings, and follow-up time were extracted.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>A total of 22 patients were identified. The mean age of diagnosis was 53 years and the average follow-up time was 23 months. Most patients demonstrated complete facial paralysis (88%) upon presentation. Nystagmus was rarely recorded during physical examination (18%, n = 4). For those patients who underwent MRI of the internal auditory canal (n = 17), 59% demonstrated enhancement of the facial nerve, with a notable absence of vestibulocochlear nerve abnormality. Of the patients who underwent vestibular testing, all demonstrated unilateral caloric weakness on videonystagmography (VNG; 66% \u00b1 22%, n = 8).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Patients with RHS polyneuropathy and vestibular complaints do not consistently demonstrate objective vestibular physical examination or imaging findings on presentation. However, VNG consistently demonstrates significant unilateral weakness on caloric stimulation. Most patients in our sample continued to have vestibular complaints at latest follow-up.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/ono.0000000000000064","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T06:00:53Z","timestamp":1734588053000},"page":"e064","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Vestibulopathy in Patients Presenting With Ramsay Hunt Syndrome"],"prefix":"10.1097","volume":"4","author":[{"given":"Erik B.","family":"Vanstrum","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Smith","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine, Los Angeles, California."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maxwell","family":"Weng","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine, Los Angeles, California."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minjung","family":"Kim","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine, Los Angeles, California."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley","family":"Kita","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2024,12]]},"reference":[{"key":"R1-20241219","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/00005053-190702000-00001","article-title":"On herpetic inflammations of the geniculate ganglion. A new syndrome and its complications.","volume":"34","author":"Hunt","year":"1907","journal-title":"J Nerv Ment Dis"},{"key":"R2-20241219","doi-asserted-by":"crossref","first-page":"S62","DOI":"10.1002\/ana.410350718","article-title":"Otological complications of herpes zoster.","volume":"35","author":"Adour","year":"1994","journal-title":"Ann Neurol"},{"key":"R3-20241219","doi-asserted-by":"crossref","first-page":"2270","DOI":"10.1002\/lary.21108","article-title":"Prognosis of Ramsay Hunt syndrome presenting as cranial polyneuropathy.","volume":"120","author":"Kim","year":"2010","journal-title":"Laryngoscope"},{"key":"R4-20241219","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1017\/S0022215100111971","article-title":"Audiological manifestations of Ramsay Hunt syndrome.","volume":"104","author":"Wayman","year":"1990","journal-title":"J Laryngol Otol"},{"key":"R5-20241219","doi-asserted-by":"crossref","first-page":"6476","DOI":"10.3390\/jcm12206476","article-title":"Herpes zoster oticus with concurrent hearing loss: a study on clinical characteristics and prognosis.","volume":"12","author":"Rim","year":"2023","journal-title":"J Clin Med"},{"key":"R6-20241219","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1288\/00005537-197703000-00010","article-title":"Auditory symptoms associated with herpes zoster or idiopathic facial paralysis.","volume":"87","author":"Byl","year":"1977","journal-title":"Laryngoscope"},{"key":"R7-20241219","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s10072-020-04536-w","article-title":"Nystagmus in Ramsay Hunt syndrome with or without dizziness.","volume":"42","author":"Lee","year":"2021","journal-title":"Neurol Sci"},{"key":"R8-20241219","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3342\/ceo.2008.1.1.15","article-title":"Statistical analysis of pure tone audiometry and caloric test in herpes zoster oticus.","volume":"1","author":"Kim","year":"2008","journal-title":"Clin Exp Otorhinolaryngol"},{"key":"R9-20241219","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1097\/NPT.0000000000000120","article-title":"Vestibular rehabilitation for peripheral vestibular hypofunction: an evidence-based clinical practice guideline: from the American Physical Therapy Association Neurology section.","volume":"40","author":"Hall","year":"2016","journal-title":"J Neurol Phys Ther"},{"key":"R10-20241219","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1001\/archotol.130.2.229","article-title":"Acute vestibular neuritis visualized by 3-T magnetic resonance imaging with high-dose gadolinium.","volume":"130","author":"Karlberg","year":"2004","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"R11-20241219","doi-asserted-by":"crossref","first-page":"427","DOI":"10.3233\/VES-1998-8603","article-title":"High resolution Gd-DTPA MR imaging of the inner ear in 60 patients with idiopathic vestibular neuritis: no evidence for contrast enhancement of the labyrinth or vestibular nerve.","volume":"8","author":"Strupp","year":"1998","journal-title":"J Vestib Res"},{"key":"R12-20241219","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1007\/s00405-020-05817-y","article-title":"Ramsay Hunt syndrome: characteristics and patient self-assessed long-term facial palsy outcome.","volume":"277","author":"Kanerva","year":"2020","journal-title":"Eur Arch Otorhinolaryngol"}],"container-title":["Otology &amp; Neurotology Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/ONO.0000000000000064","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T06:00:58Z","timestamp":1734588058000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/ONO.0000000000000064"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":12,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/ono.0000000000000064","relation":{},"ISSN":["2766-3604"],"issn-type":[{"value":"2766-3604","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}