A Suspected Atypical Case of Ramsay Hunt Syndrome Diagnosed in The Emergency Department

Abstract

Introduction: Ramsay Hunt syndrome is a rare complication of varicella zoster virus (VZV) reactivation, occurring in only approximately 0.2% of VZV reactivation cases. Despite its rarity, the morbidity associated with the syndrome is high, and the symptoms can be varied and nonspecific. Case Report: This report presents the case a 42-year-old female with an atypical presentation of Ramsay Hunt syndrome. Initially, her symptoms were concerning with regard to stroke; however, stroke workup was normal, and the consultants considered her symptoms to be the most consistent with Ramsay Hunt syndrome. Conclusion: The classical symptoms of Ramsay Hunt syndrome include otalgia; a vesicular rash in either the auditory canal, hard palate, or anterior two-third of the tongue; and ipsilateral facial paralysis or weakness. Our literature review revealed that there were no similar case reports; however, all emergency physicians should include this syndrome as part of the differential diagnosis of patients who present with unilateral paralysis