Ramsay Hunt syndrome is caused by the virus that causes chickenpox. After chickenpox clears, the virus lies dormant in nerves. Years later, it may reactivate. If the virus reactivates and affects the facial nerve, then it results in Ramsay Hunt syndrome.
Complications include permanent facial muscle weakness and deafness.
Symptoms include Ear pain, Hearing loss, tinnitus, Difficulty closing one eye, A sensation of spinning or moving (vertigo), dry eyes.
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Ramsay Hunt Syndrome
1. CASE ON RAMSAY HUNT
SYNDROME
PRESENTED BY:-
B. Sunil kumar Nayak
1
2. INTRODUCTION
• Ramsay Hunt syndrome is caused by the virus that causes
chickenpox. After chickenpox clears, the virus lies dormant in
nerves. Years later, it may reactivate. If the virus reactivates and
affects the facial nerve, then it results in Ramsay Hunt syndrome.
• Complications include permanent facial muscle weakness and
deafness.
• Symptoms include Ear pain, Hearing loss, tinnitus, Difficulty
closing one eye, A sensation of spinning or moving (vertigo), dry
eyes.
2
3. The two main signs of Ramsay
Hunt syndrome are:
• A painful red rash with fluid-
filled blisters on, in and around
one ear
• Facial weakness or paralysis on
the same side as the affected ear
3
4. PROBLEMS LIST
• Patient Demographics
Age: 75 years
Sex : Male
Unit: Male Medical Ward
No. of days hospitalised:- 12 days
• C/O Fever, Generalized weakness, Vomitings since 3 days
• MEDICAL HISTORY: Eye operation 1 month back
• MEDICATION HISTORY: Nothing significant
• SOCIAL HISTORY: occasionally toddy consumption
• FAMILY HISTORY: Nothing significant
4
10. DAY WISE ASSESSMENT
Day 2:-
• BP – 110/70 mm of Hg
• PR – 80 bpm
Day 3:-
c/o discharge from left ear
• BP- 110/70 mm of Hg
• PR- 72bpm
Day 4:-
• BP- 110/70 mm of Hg
• PR- 70 bpm
Day 5:-
• BP- 110/70 mm of Hg
• PR- 90bpm
10
11. • Day-6:-
• BP :- 100/60 mmHg
• PR :- 80 bpm
• Day-7 :-
• BP:- 120/80 mm Hg
• PR :- 70 BPM
• Day-8 :-
• No fresh complaints
• BP :- 130/80 mm Hg
• PR :- 72 bpm
11
12. OPTIMAL THERAPY
Diagnosis of Ramsay Hunt syndrome is based on medical
history, a physical exam and the disorder's distinctive signs and
symptoms.
Antiviral drugs
Acyclovir, Famciclovir, Valacyclovir
Corticosteroids
Prednisolone- Reduces the inflammation
Anti-histamines
Dimenhydrinate - To relieve vertigo
12
13. CURRENT TREATMENT
S.NO CURRENT DRUGS DOSE ROA FREQ DA DS
1 RL, NS 2 pint IV 50ml/hr 1 5
2 Inj.Ceftriaxone 1 g IV BID 1 5
4 Inj.Pantoprazole 40 mg IV OID 1 5
5 Inj.Ondansetron 4 mg IV BID 1 5
6 Tab.Paracetamol 650mg PO TID 1 9/sos
7 Inj. MethylPrednisolone 1 g in 100ml
NS
IV OD 1 2
8 Inj.Metronidazole 500mg IV TID 1 2
9 Eye vista drops 2 drops Opthlmic BID 1 9
10 Tab.Acyclovir 600mg PO TID 3 9
11 Fluticasone Ointment -- LA QID 3 9
12 Tab.Prednisolone 30mg PO BID 3 9
13 Tab.Levocetrizine 5mg PO OID 2 9
14 Tab.Cinnarizine+
Dimenhydrinate
20+40 mg PO TID 1 5
13
15. PATIENT EDUCATION
About disease
• Ramsay Hunt syndrome is caused by the virus that causes
chickenpox. Symptoms include Ear pain, Hearing loss, tinnitus,
Difficulty in closing one eye, A sensation of spinning or moving
(vertigo), dry eyes.
15
16. About drugs
• Tab.Prednisolone should be taken twice daily for 5 days.
• Tab.Paracetamol should be taken when ever there is elevation in
temperature.
• Tab.levocetrizine should be taken once daily for at night for 5 days.
• Fluticasone ointment should be locally applied on to the rashes
twice daily.
16
17. Lifestyle remedies
• Keep areas affected by the rash clean.
• Apply cool, wet compresses to the rash to decrease the pain.
• Use moisturizing eye drops throughout the day if the eye becomes
dry.
17