Sympathetic contralateral vestibulopathy after unilateral zoster oticus
- aDepartment of Neurology, bDepartment of Oto-Rhino-Laryngology, Ludwig-Maximilians University Munich, Klinikum Groβhadern, Marchioninistr. 23, D-81377 Munich, Germany
- Dr P Schulz, Department of Neurology, Klinikum Groβhadern, Marchioninistrasse 23, D-81377 München, Germany. Telephone: 0049 89 7095 4806; fax 0049 89 7095 4805; emailpschulz{at}nefo.med.uni-muenchen.de
- Received 2 April 1998
- Revised 17 November 1998
- Accepted 20 November 1998
Abstract
A unique case of initially right sided varicella zoster induced Ramsay-Hunt syndrome with complete vestibular loss is reported. The patient subsequently developed deficits of the left vestibule 5 months later. An autoimmune pathogenesis of the left vestibular failure rather than bilateral varicella zoster infection was suggested by the following data: (1) no evidence of vesicular eruptions on the left auricle and the virtual absence of antiviral antibodies after onset of bilateral vestibulopathy; (2) prompt response of the left vestibule to immunosuppressive therapy with corticosteroids; and (3) presence of atypical nervous tissue specific autoantibodies against a 45 kDa protein.
