Ramsay Hunt syndrome as a complication of Herpes Zoster: a literature revision
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Keywords

Tratamento.
Herpes vírus
síndrome

How to Cite

Rodrigues, F. A. dos S., Lima, P. M. D. D., Diniz, M. C. V., Soares, M. R., Zegas, B. A., Paz, M. L. B. D., Paz, E. S. L. D., Guaraná, C. F. R., Cavalcanti, M. T. M. de O., Cavalcanti, M. C. de O., Junior, F. B. da P., & Silveira, A. C. B. (2025). Ramsay Hunt syndrome as a complication of Herpes Zoster: a literature revision. Brazilian Journal of Implantology and Health Sciences, 7(10), 302–313. https://doi.org/10.36557/2674-8169.2025v7n10p302-313

Abstract

Introduction: Herpes zoster is a viral disease caused by the reactivation of the Varicella-zoster virus (VZV) and belongs to the Herpesviridae family. Herpes zoster can evolve into various conditions, one of which is Ramsay Hunt Syndrome (RHS), described in 1907 by neurologist James Ramsay Hunt. It occurs when herpes zoster affects the geniculate ganglion of the facial nerve, commonly seen in patients over 50 years old and/or immunocompromised. Objectives: Analyze the current evidence about RHS type II, encompassing its definition, pathophysiology, diagnostic methods, and treatment. The goal is to encourage discussion to improve clinical management and provide benefits to patients. Methodology: A systematic review was carried out involved searching descriptors on the DeCS platform. These descriptors were applied to databases such as ResearchGate, BVSALUD, PubMed, SciELO, LILACS, Medline, and Google Scholar. 1091 scientific publications were found and 36 articles were selected. Results: The results indicated that VZV reactivation can be influenced by immunosuppression, physical or psychological stress, and conditions such as diabetes. RHS type II is the most common form of this condition, manifests itself by ipsilateral facial paralysis and severe neuralgia. Early diagnosis and treatment with corticosteroids and antivirals are crucial to prevent serious complications. Conclusion: RHS type II is a complication that requires immediate clinical attention to prevent lasting damage. The importance of early diagnosis and medical treatment is highlighted. Continued studies are crucial to improve clinical management and enhance the quality of life for affected patients.

https://doi.org/10.36557/2674-8169.2025v7n10p302-313
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References

ALGAADI SA. Herpes zoster and COVID-19 infection: a coincidence or a causal relationship? Infection. 2022 Apr;50(2):289-293. doi: 10.1007/s15010-021-01714-6. Epub 2021 Nov 22. PMID: 34807403; PMCID: PMC8607065.

Almutairi N, Almutairi AN, Almazyad M, Alwazzan S. Herpes zoster in the era of COVID 19: A prospective observational study to probe the association of herpes zoster with COVID 19 infection and vaccination. Dermatol Ther. 2022 Jul;35(7):e15521. doi: 10.1111/dth.15521. Epub 2022 Apr 29. PMID: 35434963; PMCID: PMC9111648.

ANTONESCU, F. et al. Zoster Cranial Polyneuropathy in a COVID-19 Patient. American Journal of Case Reports, v. 22, 19 out. 2021.

BARROS, M. S. et al. Herpes zoster com complicações em pacientes idosos. Research, Society and Development, v. 10, n. 10, p. e208101018654–e208101018654, 8 ago. 2021.

BECERRA-MEJÍA, D., Roa-Gómez, J. D. ., Mendoza-Durán, L. D. ., Morales- Núñez, M. A., & Ramos-Villegas, Y. . (2021). Síndrome de Ramsay Hunt: revisão narrativa. ACTA DE OTORRINOLARINGOLOGÍA & CIRUGÍA DE CABEZA Y CUELLO, 49(1), 63 - 71. https://doi.org/10.37076/acorl.v49i1.522.

BROOKS JK, Rostami AM, McCorkle DC, Benesh SI. Trigeminal herpes zoster and Ramsay Hunt syndrome in an elderly adult: Presentation with prodromal toothache. Gerodontology. 2018 Sep;35(3):276-278. doi: 10.1111/ger.12340. PMID: 30465330.

CÁSSIA, L. et al. Síndrome de Ramsay Hunt e neuralgia pós-herpética como complicações de Herpes Zóster: relato de caso. v. 5, n. 6, p. 22458–22473, 10 nov. 2022.

Chen YC, Ho CH, Liu TH, Wu JY, Huang PY, Tsai YW, Lai CC. Long-term risk of herpes zoster following COVID-19: A retrospective cohort study of 2 442 686 patients. J Med Virol. 2023 Apr;95(4):e28745. doi: 10.1002/jmv.28745. Erratum in: J Med Virol. 2023 Jul;95(7):e28944. doi: 10.1002/jmv.28944. PMID: 37185849.

Crouch AE, Hohman MH, Moody MP, et al. Ramsay Hunt Syndrome. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557409/#

Dai, S., Huang, X., Chen, Y. et al. Herpes-zoster assimétrico bilateral com síndrome de Ramsay Hunt em um adulto imunocompetente. Virol J 17 , 123 (2020). https://doi.org/10.1186/s12985-020-01392-0.

Fawziah Marra, Elaine Lo, Viktor Kalashnikov, Kathryn Richardson, Risk of Herpes Zoster in Individuals on Biologics, Disease-Modifying Antirheumatic Drugs, and/or Corticosteroids for Autoimmune Diseases: A Systematic Review and Meta-Analysis, Open Forum Infectious Diseases, Volume 3, Issue 4, Fall 2016, ofw205, https://doi.org/10.1093/ofid/ofw205.

GANESAN, V. Herpes Zoster Infection Involving Mandibular Division of Trigeminal Nerve and Ramsay Hunt Syndrome with Meningitis in an Immunocompetent Patient: A Rare Association. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2016.

Ghezta NK, Bhardwaj Y, Ram R, Basi RN. Ramsay Hunt Syndrome: A diagnostic dilemma. Natl J Maxillofac Surg. 2022 Aug;13(Suppl 1):S179-S182. doi: 10.4103/njms.NJMS_259_20. Epub 2022 Aug 20. PMID: 36393956; PMCID: PMC9651248.

Gondivkar S, Parikh V, Parikh R. Herpes zoster oticus: A rare clinical entity. Contemp Clin Dent. 2010 Apr;1(2):127-9. doi: 10.4103/0976-237X.68588. PMID: 22114399; PMCID: PMC3220085.

Goswami, Yuktam e Sagar S Gaurkar. Síndrome de Hunt de Ramsay: uma Introdução, Sinais e Sintomas e Tratamento. Cureus vol. 15,1 e33688. 12 de Janeiro de 2023, doi:10.7759/cureus.33688.

GROSE, C.; SHABAN, A.; FULLERTON, H. J. Common Features Between Stroke Following Varicella in Children and Stroke Following Herpes Zoster in Adults. Springer eBooks, p. 247–272, 1 jan. 2021.

GUIMARÃES, F. Como identificar uma manifestação oral de Herpes-Zoster? Research, Society and Development, v. 10, n. 2, p. e31610212617–e31610212617, 17 fev. 2021.

HSU, P.-Y.; JANG, T.-Y. Hypopharyngeal and Laryngeal Lesions in a Patient with Chickenpox. Ear, Nose & Throat Journal, v. 100, n. 10_suppl, p. 1029S1030S, 18 jun. 2020.

Hwang, Y.S., Kim, Y.S., Shin, BS. et al. Two cases of Ramsay-Hunt syndrome following varicella zoster viral meningitis in young immunocompetent men: case reports. BMC Neurol 23, 43 (2023). https://doi.org/10.1186/s12883-023-03074-0.

Malhotra, Ritika et al. Características clínicas e Prognosis de Palsia Facial e Perda Auditiva em pacientes com Síndrome de Ramsay Hunt. Cureus vol. 14,10 e30897. 31 de outubro de 2022, doi:10.7759/cureus.30897.

Moore, Keith L.; DALLEY, Arthur F.. Anatomia orientada para a clínica. 9 Rio De Janeiro: Editora Guanabara Koogan S.A., 2023, 1074 p.

Mónica Marcela Macías Ortega1 , Andrea M. Agurcia2 , Jovanna R. Andrade-Romero2. et al. SÍNDROME DE RAMSAY HUNT TIPO II EN MUJER MAYOR DE 90 AÑOS. Julio - Diciembre 2017. https://pesquisa.bvsalud.org/portal/resource/pt/biblio-882722

Monsanto RD, Bittencourt AG, Bobato Neto NJ, Beilke SC, Lorenzetti FT, Salomone R. Treatment and Prognosis of Facial Palsy on Ramsay Hunt Syndrome: Results Based on a Review of the Literature. Int Arch Otorhinolaryngol. 2016 Oct;20(4):394-400. doi: 10.1055/s-0036-1584267. Epub 2016 May 30. PMID: 27746846; PMCID: PMC5063726.

MUSTELIER-GUTIERREZ, Ana Celia; BELON-CALDERIN, Ramona Beatriz; NUNEZ-OLIVERO, Acelia. Síndrome de Ramsay Hunt. Informe de um caso e revisão de la literatura. Rev. inf. cient., Guantánamo, v. 99, n. 3, p. 266-273, jun. 2020. Disponível em: <http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1028-99332020000300266&lng=es&nrm=iso>. accedido en 18 jul. 2024. Epub 14-Sep-2020.

PATIDAR, M. et al. Ramsay hunt syndrome: A diagnostic challenge for general dental practitioners. Contemporary Clinical Dentistry, v. 8, n. 2, p. 337, 2017.

SAITOH, H. et al. Viable herpes simplex virus type 1 and varicella-zoster virus in the trigeminal ganglia of human cadavers. Journal of Medical Virology, v. 85, n. 5, p. 833–838, 27 fev. 2013.

SEUNG, H.; SIM, W.-S.; ROE, H.-J. Auriculotemporal and greater auricular nerve blocks have roles in patients with Ramsay Hunt syndrome with trigeminal nerve involvement -A report of two cases. [s.l: s.n.]. Disponível em: https://anesth-pain-med.org/upload/pdf/Apm007-01-04.pdf. Acesso em: 22 jul. 2024.

Shoji H, Mizoguchi M, Yamamoto S, Abe T, Oguri S, Baba M. [Herpes zoster duplex associated with Ramsay Hunt syndrome and cervical zoster paresis. A case report]. Rinsho Shinkeigaku. 2021 Jan 29;61(1):39-42. Japanese. doi: 10.5692/clinicalneurol.cn-001526. Epub 2020 Dec 15. PMID: 33328423.

Singh G, Subhalakshmi V, Balasubramanian S, Patidar M, Ealla KKR. Ramsay Hunt Syndrome: A Diagnostic Challenge for General Dental Practitioners. Contemp Clin Dent. 2017 Apr-Jun;8(2):337-339. doi: 10.4103/ccd.ccd_1099_16. PMID: 28839425; PMCID: PMC5551344.

SINHA, R. et al. Clinical and Epidemiological Profile of Herpes Zoster and Its Complications in a Tertiary Care Center of Bihar: A Prospective Study. Cureus, v. 15, n. 8, p. e43560, 1 ago. 2023.

SOCCOL BERALDIN, B. et al. Síndrome de Ramsay Hunt: Relato de Caso. Arquivos Catarinenses de Medicina, v. 37, 2008.

Stornaiuolo A, Iodice R, De Simone R, Russo C, Rubino M, Braca S, Miele A, Tozza S, Nolano M, Manganelli F. Multiple cranial neuropathy due to varicella zoster virus reactivation without vesicular rash: a challenging diagnosis. Neurol Sci. 2023 Oct;44(10):3687-3689. doi: 10.1007/s10072-023-06833-6. Epub 2023 May 9. PMID: 37156980; PMCID: PMC10495477.

Umakanthan S, Sahu P, Ranade AV, Bukelo MM, Rao JS, Abrahao-Machado LF, Dahal S, Kumar H, Kv D. Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19). Postgrad Med J. 2020 Dec;96(1142):753-758. doi: 10.1136/postgradmedj-2020-138234. Epub 2020 Jun 20. PMID: 32563999; PMCID: PMC10016932.

VALERIO, Enrico et al. Ramsay Hunt Syndrome. Pediatric Neurology, v. 52, n. 5, p. 554-555, 2015.

Vargas, I. C. et al. Síndrome de Ramsay Hunt: uma abordagem diagnóstica, evolução clínica e revisão. Brazilian Journal of Health Review, v. 6, n. 5, p. 21447–21455, 16 set. 2023.

Vista de Síndrome de Ramsay Hunt: revisión narrativa. Disponível em: https://revista.acorl.org.co/index.php/acorl/article/view/522/491. Acesso em: 22 jul. 2024

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This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2025 Fábio Alexandre dos Santos Rodrigues, Pollyana Menezes Duram De Lima, Maria Cecília Vicente Diniz, Millena Rodrigues Soares, Bruna Araújo Zegas, Matheus Lyra Braga Da Paz, Eliana Santos Lyra Da Paz, Carlos Fernando Rodrigues Guaraná, Maria Tereza Moura de Oliveira Cavalcanti, Maria Clara de Oliveira Cavalcanti, Francisco Braga da Paz Junior, Ana Cristina Barreto Silveira

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