Pediatr. praxi. 2026;27(3):192-194 | DOI: 10.36290/ped.2026.032
Ramsay Hunt syndrome complicated by varicela zoster virus associated meningoencephalitis in a six-year-old girl
- 1 Dětská klinika LF UP a FN v Olomouci
- 2 Radiologická klinika LF UP a FN v Olomouci
- 3 Klinika otorinolaryngologie a chirurgie hlavy a krku LF UP a FN v Olomouci
Ramsay Hunt syndrome (RHS) is caused by reactivation of the varicela zoster virus, which persists in a latent state in the geniculate ganglion after primary infection with chickenpox. The syndrome is characterized by a combination of peripheral facial nerve palsy, a painful herpetiform vesicular eruption on the ear auricle and in the external auditory canal, and possible accompanying vestibulocochlear symptoms with disturbances of taste, hearing, or balance. It occurs less frequently in children and generally has a milder course than in adults. The syndrome accounts for approximately 15% of cases of facial nerve palsy in children. Rarely, it can be complicated by varicela meningoencephalitis. We present a 6‑year‑old girl with a full clinical presentation of RHS complicated by varicela meningoencephalitis, successfully treated with acyclovir.
Keywords: Ramsay Hunt syndrome, varicela meningoencephalitis, acyclovir, child.
Accepted: June 22, 2026; Published: July 1, 2026 Show citation
References
- Hunt JR. On herpetic inflammations of the geniculate ganglion: a new syndrome and its complications. J Nerv Ment Dis. 1907;34:73-96.
Go to original source... - Hato N, Kisaki H, Honda N, et al. Ramsay Hunt syndrome in children. Ann. Neurol. 2000;48(2):254-256. Go to original source...
- Ogita S, Terada K, Niizuma T, et al. Characteristic of facial nerve palsy during childhood in Japan: frequency of varicela zoster virus association. Pediatr Int. 2006;48(3):245-249. Go to original source...
- Mattox DE. Clinical disorders of the facial nerve, in: Cummings CW, Fredrickson JM, Harker LA, et al. OtolaryngologyHead and Neck Surgery. 3rd ed., Mosby-YearBook, St. Louis, MO. 1998, p. 2773.
- Vlčková E, Švecová E, Štourač P, et al. PCR diagnostika herpetických virů u pacientů s akutní parézou lícního nervu. Cesk Slov Neurol N. 2008;71/107(2):201-205.
- Kennedy PG. Varicela zoster virus latency in human ganglia. Rev Med Virol. 2002; 12:327-334. Go to original source...
- Balatsouras DG, Rallis E, Homsioglou E, et al. Ramsay Hunt syndrome in a 3-month-old infant. Pediatr Dermatol. 2007; 24(1):34-37. Go to original source...
- Furuta Y, Ohtani F, Sawa H, et al. Quantitation of varicela zoster virus DNA in patients with Ramsay Hunt syndrome and zoster sine herpete. JClinMicrobiol. 2001; 39(8):2856-2859. Go to original source...
Go to PubMed... - Kinishi M, Amatsu M, Mohri M, et al. Acyclovir improves recovery rate of facial nerve palsy in Ramsay Hunt syndrome. AurisNasus Larynx. 2001;28(3):223-226. Go to original source...
- Kneen R, Michael BD, Menson E, et al. Management of suspected viral encephalitis in children - Association of British Neurologists and British Paediatric Allergy, Immunology and Infection Group nationalguidelines. J Infect. 2012;64:449-477. Go to original source...
- Ahmed EY, Rawahi HA, Amrani FA, et al. Ramsay Hunt syndrome associated with varicela zoster virus encephalitis in a child. SultanQaboosUniv Med J. 2024;24(1):127-130. Go to original source...
- Papanikos V, Chaniotaki N, Batsaouras G, et al. A rare case of Ramsey Hunt syndrome with cranial polyneuropathy: findings of the brain MRI. Cureus. December 16, 2024;16(12): e75817. DOI 10.7759/cureus.75817. Go to original source...
- Kansu L, Yilmaz I. Herpes zoster oticus (Ramsay Hunt syndrome) in children: case report and literature review. Int J Pediatr Otorhinolaryngol. 2012;76(6):772-776. Go to original source...
- Bjerkhoel A, Hydén D. Ramsay-Hunt syndrome in a preschool infant. ORL J Otorhinolaryngol Relat Spec. 1989; 51(4):251-254. Go to original source... Go to PubMed...
- Derin S, Derin H, Sahan M, et al. A pediatric case of Ramsay Hunt syndrome. Case Rep Otolaryngol. 2014;469565. doi: 10.1155/2014/469565. Epub 2014 Sep 8. PMID: 25276457; PMCID: PMC4172874. Go to original source...
- Masukume G, Chibwowa S, Ndlovu M. Full recovery of a 13-year-old boy with pediatric Ramsay Hunt syndrome using a shorter course of aciclovir and steroid at lower doses: a case report. J Med Case Rep. 2011;5:376. doi: 10.1186/1752-1947-5-376. PMID: 21843319; PMCID: PMC3170352. Go to original source... Go to PubMed...
- Slivka M. Ramsay-Huntův syndrom. NeurolPrax. 2001;3: 144-146.
- Michal L, Szilágyiová M, Kurča E, et al. Ramsay-Huntov syndróm. Klin Mikrobiol Inf Lek. 2003;3:143-145.
- Rosoľanka R, Šimeková K. Ramsay-Huntov syndróm-vzácna manifestácia pomerne častého ochorenia. Cesk Slov Neurol N. 2016;79/112(2):222-224.