Ramsay Hunt Syndrome
Findings:
Coronal and axial fat suppressed T1 post contrast images demonstrate abnormal patchy enhancement involving the intracanalicular segment of the right seventh eighth nerve complex. The enhancement caps the IAC and there is also a symmetric enhancement of the entirety of the right facial nerve. Very subtle asymmetric enhancement is questioned in the lateral margin of the right external auditory canal.
Discussion:
Ramsay Hunt Syndrome is also known as herpes zoster oticus. The process may begin with a vesicular rash in the external ear and facial palsy, and may also be associated with other seventh eighth nerve complex symptoms such as vertigo and hearing loss. Facial palsy is typically more severe than the mote common post viral Bell’s palsy. It is usually diagnosed clinically without imaging. Linear/patchy IAC fundal enhancement is characteristic, and EAC enhancement may also be seen. There is usually enhancement of the entire seventh nerve within the temporal bone which may also involve the membranous labyrinth.