Abstract:
Ramsay Hunt syndrome (RHS) is a manifestation of reactivated varicella-zoster virus (VZV) from the geniculate ganglion. Data on clinical features and outcomes of patients with RHS and concurrent VZV meningitis (henceforth RHS meningitis) are limited. Thus, we conducted a nationwide population-based cohort study of all adults hospitalized for RHS meningitis at the departments of infectious diseases in Denmark from 2015 to 2020. Patients with VZV meningitis without cranial nerve palsies were included for comparison. In total, 37 patients with RHS meningitis (mean annual incidence: 1.6/1 000 000 adults) and 162 with VZV meningitis without cranial nerve palsies were included. In RHS meningitis, the median age was 52 years (interquartile range: 35-64), and in addition to peripheral facial nerve palsy (100%), dizziness (46%), and hearing loss (35%) were common symptoms. The triad of headache, neck stiffness, and photophobia/hyperacusis was less common in RHS meningitis than in VZV meningitis without cranial nerve palsies (0/27 [0%] vs. 24/143 [17%]; p = 0.02). At 30 days after discharge, 18/36 (50%) patients with RHS meningitis had persistent peripheral facial nerve palsy, with no statistically significant difference between those treated with and without adjuvant glucocorticoids (6/16 [38%] vs. 12/20 [60%]; p = 0.18). Additional sequelae of RHS meningitis included dizziness (29%), neuralgia (14%), tinnitus/hyperacusis (11%), hearing loss (9%), headache (9%), fatigue (6%), and concentration difficulties (3%). In conclusion, clinical features and outcomes of RHS meningitis were primarily related to cranial neuropathies.
摘要:
RamsayHunt综合征(RHS)是来自膝状神经节的水痘带状疱疹病毒(VZV)的再激活表现。关于RHS和并发VZV脑膜炎(以下简称RHS脑膜炎)患者的临床特征和结果的数据有限。因此,我们在2015年至2020年期间,对丹麦各传染病科因RHS脑膜炎住院的所有成年人进行了一项基于人群的全国性队列研究.包括没有颅神经麻痹的VZV脑膜炎患者进行比较。总的来说,包括37例RHS脑膜炎患者(平均年发病率:1.6/1000000名成人)和162例无颅神经麻痹的VZV脑膜炎患者。在RHS脑膜炎中,中位年龄为52岁(四分位距:35-64),除了周围性面神经麻痹(100%),头晕(46%),听力损失(35%)是常见症状。头痛的三合会,颈部僵硬度,在RHS脑膜炎中,畏光/高音的发生率低于没有颅神经麻痹的VZV脑膜炎(0/27[0%]vs.24/143[17%];p=0.02)。出院后30天,18/36(50%)RHS脑膜炎患者有持续性周围性面神经麻痹,使用和不使用辅助糖皮质激素治疗的患者之间没有统计学上的显着差异(6/16[38%]vs.12/20[60%];p=0.18)。RHS脑膜炎的其他后遗症包括头晕(29%),神经痛(14%),耳鸣/高音(11%),听力损失(9%),头痛(9%),疲劳(6%),和浓度困难(3%)。总之,RHS脑膜炎的临床特征和结局主要与颅神经病变相关.