Gülbahar Saraç, Mustafa Şenol, Hatice Gamze Demirdağ, Nihal Altunışık

Maksiller Dermatomu Tutan Bir Ramsay-Hunt Sendromu Olgusu

Herpes zoster (HZ) varisella enfeksiyonu sonrası arka kök gangliyonlarına yerleşen varisella zoster virüsünün (VZV) reaktivasyonu sonucu, latent kaldığı gangliyonun innerve ettiği dermatom bölgesinde veziküler lezyonlarla ortaya çıkar. Sıklıkla yaşamın ilerleyen dönemlerinde görülür. Zonada en sık tutulum torasik dermatomda olmaktadır. Kraniyal sinir tutulumu ise en sık olarak trigeminal sinirde olup, oftalmik dalın etkilenmesi (oftalmik zona), maksiller ve mandibuler dal tutulumuna göre yaklaşık yirmi kat daha sıktır. Ramsay-Hunt sendromu, varisella zoster virüsünün reaktivasyonuyla ortaya çıkan bir kraniyal polinöropatidir. Herpes zoster enfeksiyonları içerisindeki sıklığı %1 olarak tanımlanmıştır. Maksiller dal tutulumunun nadir olması ve beraberinde Ramsay-Hunt sendromu bulunması yönüyle enteresan bulunan hastanın sunulması uygun görülmüştür. Anahtar Kelime: Ramsay Hunt Sendromu; Herpes Zoster; Maxiller Zona Zoster.

Anahtar Kelimeler:

Ramsay Hunt Sendromu; Herpes Zoster; Maxiller Zona Zoster

Ramsay-Hunt Syndrome with Maxillary Dermatome Involvement: A Case Report

Herpes zoster (HZ) is caused by the reactivation of varicella zoster virus (VZV) that remains latent in the dorsal root ganglia after varicella infection. During the course of the disease, vesicular eruptions appear on skin of the innerved dermatome. Herpes zoster usually occurs in elderly patients. Thoracic dermatome is the most involved area in HZ. Trigeminal nerve is the most affected cranial nerve and ophthalmic branch of the trigeminal nerve involvement (ophtalmic zona) is twenty times more frequent in comparison with involvement of maxillary and mandibular branches. Ramsay-Hunt syndrome is a cranial polyneuropathy following VZV reactivation. The frequency of Ramsay-Hunt syndrome is defined as %1 in HZ infections. We present this interesting case because maxillary branch involvement with Ramsay-Hunt syndrome is a rare combination. Key words: Ramsay Hunt Syndrome; Herpes Zoster; Maxillary Zona Zoster.

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Arvin AM. Varicella-zoster virus: molecular virology and virus-host interactions. Curr Opin Microbiol 2001;4:442-9.
Straus SE, Oxman MN. Varicella and Herpes Zoster. In: Fitzpatrick TB, Eisen AZ, Wolf K, eds. Dermatology in General Medicine. 5th edition. McGraw-Hill;1999. p. 2427- 50.
Sterling JC, Kurtz JB. Viral infections. Champion RH, Burton JL. Burns DA Breathnach SM, eds. Textbook of Dermatology. 6th edition. Blackwell Scientific;1998. p. 995- 1095.
Covucci AL. Paresis of cranial nerves 3, 4, and 6 associated with herpes zoster ophthalmicus: a case report. Clin Eye Vision Care 1999;11:159-63.
Öztürkcan S. Herpes zoster (Zona, Gece Yanığı). Tüzün Y, Gürer MA, Serdaroğlu S, Oğuz O, Aksungur VL, editörler. Dermatoloji. 3.baskı, Nobel Tıp Kitapevleri;2008. p.607-14.
McCrary ML, Severson J, Tyring SK. Varicella zoster virus. J Am Acad Dermatol 1999;41:1-14.
Asnis DS, Micic L, Giaccio D. Ramsay Hunt syndrome presenting as a cranial polyneuropathy. Cutis 1996;57:421- 4.
Erdal E. Viral Hastalıklar. Tüzün Y, Kotoğyan A, Serdaroğlu S, editörler. Pediatrik Dermatoloji. 1. Baskı. Nobel Tıp Kitapevleri; 2005. p. 607-44.
Neville BW, Damm DD, Allen MC, Bouquot EJ. Maxillofacial Pathology.Oral and Maxillofacial Pathology. 1st edition. WB Saunders; 1995:p189.
Gross G, Schöfer H, Wassilew S, Friese K, Timm A, Guthoff R,et al. Herpes zoster guideline of the German Dermatology Society. J Clin Virol 2003;26:277-89.
Gilden DH, Kleinschmidt-DeMasters BK, LaGuardia JJ, Mahalingam R, Cohrs RJ. Neurologic complications of the reactivation of varicella-zoster virus. N Engl J Med. 2000;342:635-45.
May M, Shambough GE. Facial nerve paralysis. Paparella MM, Schumrick DA, Gluckman JL, Meyerhaff WC, eds. Otolaryngology. 3rd edition. WB Saunders; 199. p. 1097- 136.
Chang CM, Woo E, Yu YL, Huang CY, Chin D. Herpes zoster and its neurological complications. Postgrad Med J 1987;63:85-9.
Baba M, Seçkin D, Eryılmaz A, Gençay S. Atipik seyirli Ramsay-Hunt sendromlu bir olgu. Türkderm 2006;40: B80-1.
Murakami S, Hato N, Horiuchi J, Honda N, Gyo K, Yanagihara N. Treatment of Ramsay-Hunt syndrome with acyclovir-prednisone: significance of early diagnosis and treatment. Ann Neurol 1997;41:353-7.