ENT Department treats woman for Ramsay Hunt syndrome
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There was significant improvement in facial paralysis and rash after 5 days of treatment. Patient was discharged on tapering doses of steroids with advice to follow up after 1 week.
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ENT Department treats woman for Ramsay Hunt syndrome
- 1. Department of ENT & head and neck surgeryDepartment of ENT & head and neck surgery Capital hospitalCapital hospital Dr. Sumiyya House Surgeon, ENT Department
- 2. Name: xyz Address: Islamabad Age: 48 years Sex: Female DOA: 10-09-14 on Dept. of Dermatology Seen in ENT: 17-09-14 Patient Profile
- 3. Main Complaint: Rash around chin, and lips Deviation of angle of mouth to left and inability to close Rt. Eye. Ear ache, not associated with tinnitus and vertigo. HISTORY
- 4. History of presenting Illness: Patient was alright when she developed a rash around the chin, and lips for which she presented in dermatology where she was admitted on 10-09-14. The onset was acute. The rash was also associated in pain in the same area and in the right ear. Pain was relieved temporarily with pain killers. The rash and pain also started settling during treatment in the dermatology department during admission. She also noted deviation of angle of mouth to left side and inability to close right eye from ----. This was not associated with any aggravating or relieving factors.
- 5. Past History: No past H/o any significant medical disease No Past H/o any surgery Personal History: Seep and Appetite normal No C/o Fever. No addiction
- 6. General Physical Examination A middle aged lady, well oriented in time space and person. Pulse: 115/min Temp: Afebrile Pallor: -ve Jaundice: -ve Dehydration: -ve Cyanosis: -ve Clubbing: -ve Edema: -ve Cx. Nodes: Not palpable
- 7. Vesiculopapular rash on pinna and extenal auditory canal of Right ear Tympanic membranes of both ear is normal Hearing as assessed by speech test and tunning fork tests appeared normal. No spontaneous or induced nystagmus noted. Vestibular and cerebellar function tests were normal. EXAMINTAION OF EAR
- 8. There was complete Rt. Sided lower motor neuron facial paralysis evident by: Loss of Forehead wrinkling Inability to close eyelids Loss of Blinking reflex Inability to perform sniffing movement. Absence of nasolabial fold Inability to do Whistling Drooping of angle of mouth FACIAL NERVE EXAMINATION
- 9.
- 10. House Brackmann Grading: Grade iv (Disfiguring)
- 11. Poor hygiene Vesicular rash around upper and lower lips and inside mouth No abnormality detected THROAT EXAMINATION NOSE EXAMINATION
- 12. Cardio-Respiratory System: S1 +S2 audible in all four areas. Chest Clear with NVB GIT: NAD No Scar No Swelling No Tenderness CNS: No neurologic deficit noted Cranial nerves assessment. No other cranial nerve deficit noted except Rt. Facial nerve Systemic Examination
- 13. No radiological and electrophysiological tests were done as diagnosis was made on clinical basis and improvement had started.
- 15. Patient is treated with: Tab vatrex 8 mg in TDS Tab chymrol forte in TDS Tab prednisolne 5 mg in TDS Cap risek 20 mg in BD Artificial Tears TREATMENT
- 16. OUTCOME