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Trigeminal herpes zoster and Ramsay Hunt syndrome with a lesion in the spinal trigeminal nucleus and tract. 2010

Chia-Wei Hung, and Shuu-Jiun Wang, and Shih-Pin Chen, and Jiing-Feng Lirng, and Jong-Ling Fuh

We report the case of a 77-year-old immuno-competent man who developed herpes zoster in the maxillary and mandibular branches of the trigeminal nerve. Within 3 weeks, he developed ipsilateral peripheral facial palsy, hearing loss, vesicles over the external auditory canal, and pain in the face and ear. A T(2)-weighted MRI of the brain revealed a hyper-intense lesion at the right medulla corresponding to the spinal trigeminal nucleus and tract. Gadolinium enhancement was seen over the right facial nerve. These lesions suggest a possibility of transaxonal spread of the varicella zoster virus between the trigeminal nerve, the facial nerve, and the spinal trigeminal nucleus and tract.

UI MeSH Term Description Entries
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D009434 Neural Pathways Neural tracts connecting one part of the nervous system with another. Neural Interconnections,Interconnection, Neural,Interconnections, Neural,Neural Interconnection,Neural Pathway,Pathway, Neural,Pathways, Neural
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D005154 Facial Nerve The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and SALIVARY GLANDS, and convey afferent information for TASTE from the anterior two-thirds of the TONGUE and for TOUCH from the EXTERNAL EAR. Cranial Nerve VII,Marginal Mandibular Branch,Marginal Mandibular Nerve,Seventh Cranial Nerve,Nerve VII,Nerve of Wrisberg,Nervus Facialis,Nervus Intermedius,Nervus Intermedius of Wrisberg,Cranial Nerve VIIs,Cranial Nerve, Seventh,Facial Nerves,Mandibular Nerve, Marginal,Mandibular Nerves, Marginal,Marginal Mandibular Nerves,Nerve VIIs,Nerve, Facial,Nerve, Marginal Mandibular,Nerve, Seventh Cranial,Nerves, Marginal Mandibular,Nervus Faciali,Seventh Cranial Nerves,Wrisberg Nerve,Wrisberg Nervus Intermedius
D006562 Herpes Zoster An acute infectious, usually self-limited, disease believed to represent activation of latent varicella-zoster virus (HERPESVIRUS 3, HUMAN) in those who have been rendered partially immune after a previous attack of CHICKENPOX. It involves the SENSORY GANGLIA and their areas of innervation and is characterized by severe neuralgic pain along the distribution of the affected nerve and crops of clustered vesicles over the area. (From Dorland, 27th ed) Shingles,Zona,Zoster
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D014279 Trigeminal Nucleus, Spinal Nucleus of the spinal tract of the trigeminal nerve. It is divided cytoarchitectonically into three parts: oralis, caudalis (TRIGEMINAL CAUDAL NUCLEUS), and interpolaris. Nucleus, Spinal Trigeminal,Spinal Trigeminal Nucleus
D016697 Herpes Zoster Oticus A syndrome characterized by facial palsy in association with a herpetic eruption of the external auditory meatus. This may occasionally be associated with tinnitus, vertigo, deafness, severe otalgia, and inflammation of the pinna. The condition is caused by reactivation of a latent HERPESVIRUS 3, HUMAN infection which causes inflammation of the facial and vestibular nerves, and may occasionally involve additional cranial nerves. (From Adams et al., Principles of Neurology, 6th ed, p757) Geniculate Herpes Zoster,Neuralgia, Geniculate,Ramsay Hunt Auricular Syndrome,Ramsay Hunt Syndrome,Auricular Syndrome of Ramsay Hunt,Herpes Zoster Auricularis,Herpes Zoster Cephalicus,Herpetic Geniculate Ganglionitis,Ganglionitis, Herpetic Geniculate,Geniculate Ganglionitides, Herpetic,Geniculate Ganglionitis, Herpetic,Geniculate Neuralgia,Geniculate Neuralgias,Herpes Zoster, Geniculate,Herpetic Geniculate Ganglionitides,Neuralgias, Geniculate,Syndrome, Ramsay Hunt

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