Tai có thể trở thành màu đỏ và dịu dàng. Tê liệt thường nghiêm trọng và đầy đủ và đau dây thần kinh sau herpes có thể xảy ra. Các bệnh nhân trong các họa tiết đỏ tai và sự dịu dàng và trái bại hoàn toàn dây thần kinh VII ngoại vi cũng có thể đại diện cho một trường hợp của RHS. | 120 11. Headache and Facial Pain disorders causing facial paresis include herpes zoster ce-phalicus Ramsey Hunt syndrome acute inflammatory demyelinating polyradiculopathy Guillain-Barre syndrome infectious mononucleosis Lyme disease and others chickenpox mumps influenza HIV leprosy mucormycosis and so on . Ramsay Hunt syndrome RHS caused by herpes zoster virus infection is characterized by excruciating ear pain accompanied by a vescicular eruption involving the external canal and pinna that can precede accompany or follow the onset of the facial paralysis. The ear can become red and tender. The paralysis is often severe and complete and postherpetic neuralgia may occur. The patient in the vignette with ear redness and tenderness and complete left VII nerve peripheral palsy may well represent a case of RHS. The diagnosis does not present difficulty in the presence of the typical skin rash. Oral acyclovir is the preferred treatment. Facial weakness can be an important manifestation of Guillain-Barre syndrome and Lyme disease where it is often bilateral. In GBS cardinal features include symmetrical proximal weakness and hypo-areflexia. Lyme disease is also characterized by generalized weakness fatigue headache fever and so on. Infectious mononucleosis rarely is responsible for unilateral recurrent or bilateral facial paralysis. Complicated infections of the middle ear with involvement of the petrous apex particularly in children can be responsible for the so-called Gradenigo s syndrome characterized by severe ear pain and involvement of multiple cranial nerves such as the ophthalmic division of the trigeminal nerve the abducens and facial nerve. Primary and metastatic tumors may cause facial nerve dysfunction along its course but usually there are other signs and symptoms that suggest a more widespread involvement of other organs and neurological structures. Nuclear and fascicular pontine lesions involving the facial nerve due to vascular processes or tumors also .
