1例以前庭神经损害为首发症状Ramsay Hunt综合征伴发病毒性脑膜炎治疗报告  

Vestibular nerve damage as the initial symptom of Ramsay Hunt syndrome with pathogenic toxic meningitis:a case report

作　　者：郭功兵 GUO Gongbing(Shiyan Taihe Hospital(Affiliated Hospital of Hubei Medical College),Shiyan 442000,China)

机构地区：[1]十堰市太和医院(湖北医药学院附属医院)综合医疗科,442000

出　　处：《中国老年保健医学》2023年第4期137-138,共2页Chinese Journal of Geriatric Care

摘　　要：水痘-带状疱疹病毒为DNA病毒,具有嗜神经特征,感染机体后长期潜伏于脊神经背根神经节或三叉神经节及颅神经细胞内。当机体免疫功能低下时,潜伏的病毒被激活并复制,通过神经轴突到达神经支配区引起神经损害表现。Ramsay Hunt综合征为面神经膝状神经节水痘-带状疱疹病毒感染,临床可表现为周围性面瘫、舌前2/3味觉障碍、泪腺及唾液腺分泌障碍,可伴听觉过敏,耳后剧烈疼痛,骨膜及外耳道疱疹,最常见面神经单一神经损害。本文报道1例以前庭神经损害为首发症状的Hunt综合征伴发病毒性脑膜炎病例,以提高临床对Ramsay Hunt综合征认识。本病例诊治经历提示,早发现,早诊断,及时抗病毒联合大剂量糖皮质激素、丙种球蛋白冲击、前庭康复训练、营养神经制剂综合治疗,有助于神经功能恢复,减少该病后遗症的发生,提高患者生活质量。Varicella-zoster virus is a DNA virus with neurophilic characteristics.After infection,varicella-zoster virus is latent in the dorsal root ganglion or trigeminal ganglion of spinal nerve and cranial nerve cells for a long time.When the immune function of the body is low,the latent virus is activated and replicated,and reaches the innervation area through nerve axons,causing nerve damage.Hunt syndrome is a varicella zoster virus infection of the facial nerve geniculate ganglion,which can be clinically manifested as peripheral facial palsy,taste disturbance of the front 2/3 of the tongue,secretion disturbance of lacrimal gland and salivary gland,accompanied by auditory allergy,severe pain behind the ear,periosteal and external ear canal herpe,and the most common single nerve damage of the facial nerve.This article reports a case of Hunt syndrome with vestibular lesion as the first symptom accompanied by pathogenic toxic meningitis,in order to improve clinical understanding of Ramsay-Hunt syndrome.The diagnosis and treatment experience of this case suggests that early detection,early diagnosis,timely antiviral combined with high-dose glucocorticoid,gamma globulin shock,vestibular rehabilitation training,and comprehensive treatment of nutritional nerve preparation is conducive to the recovery of neurological function,reduce the occurrence of sequelae of the disease,and improve the quality of life of patients.

关 键 词：前庭神经 RAMSAY HUNT综合征 亨特氏综合征 病毒性脑膜炎 

分 类 号：R512.3[医药卫生—内科学]