ECE2023 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (355 abstracts)
Ramsay Hunt syndrome in a diabetic patient: A case report
Houas Jihene 1 , Naouar Maroua 1 , Ghammam Monia 1 , Bergaoui Emna 1 , El Omri Malika 1 , Bellakhdher Mouna 1 , Hasni El Abed Yosra 2 , Meherzi Abir 1 , Kermani Wassim 1 & Abdelkefi Mohamed 1
1ENT Department and Neck Surgery of Farhat Hached Hospital, Sousse, Tunisia; 2Endocrinology Department, Farhat Hached Hospital, Sousse, Tunisia.
Introduction: Ramsay Hunt syndrome or Herpes Zoster Oticus is characterized by reactivation of latent varicella zoster virus in the geniculate ganglion and subsequent spread to cranial nerve. The diagnosis is mainly clinical. The facial paralysis seen in Ramsay Hunt syndrome is often more severe with the increased rate of late neural denervation and the decrease chance of complete recovery especially in diabetic patients. The aim of this study is to focus on the association between diabetes mellitus and Ramsay Hunt syndrome.
Case presentation: A 38-year-old woman with history of diabetes mellitus, on oral antidiabetic drugs and insulin, presented to ENT emergency with 4 days history of right-sided earache followed by the development of vesicular rash involving the right pinna. Physical examination revealed right-sided grade IV facial nerve palsy. The right ear had a cluster of vesicles on the concha and antihelix associated to perforated tympanic membrane in the otoscopy. Audiometry was normal. Random blood sugar was 18.3 mmol/l. We made a diagnosis of Ramsay Hunt syndrome and administered acyclovir 500 mg 4 times daily for 12 days and solumedrol 80 mg daily for 10 days. Two weeks after initiation of the treatment vesicular lesions disappeared but neurological examination revealed right-sided grade II facial nerve palsy. Blood sugar was well controlled.
Conclusion: Ramsay Hunt syndrome is one of the least frequent causes of facial palsy, inducing severe dysfunction and of poorer prognosis for the facial nerve than Bell’s palsy. Associated acyclovir and high-dose corticosteroids with well controlled blood sugar improve facial nerve functional recovery in diabetic patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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