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Suffering From Ramsay Hunt Syndrome Type 2. Have Swollen Node Of Neck. Is This Same As Shingles?

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Posted on Wed, 25 Jul 2012
Question: Hi if I have XXXXXXX Hunt Syndrome Type 2 (Herpes Zoster Oticus) is that the same as Shingles, and is that the reason why desides the symptoms of XXXXXXX Hunt Syndrome Type 2 that I also have a scant clear runny nose, and swelling in the front lymph node of the neck and in front of my right ear?
doctor
Answered by Dr. Sumit Bhatti (1 hour later)
Hi,

Thank you for your query.

1. XXXXXXX Hunt Syndrome Type 2 is the same as Shingles. Shingles refers to herpes zoster infecting any cutaneous nerve in the body while Herpes Zoster Oticus indicates involvement of the facial nerve (Seventh Cranial nerve)

2. Herpes zoster oticus also cause reduction in secretions. Scanty nasal secretions may be due to reflex dysfunction or infection spreading to the Trigeinal Nerve (Fifth Cranial nerve) via unnamed connecting branches.

3. The lymph nodes are swollen due to this infection and inflammation.

4. In my experience, a herpes reactivation many a times signifies some stress or weakness in the body which allows the dormant virus to surface again. Be sure to rule out Lyme Disease.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (35 hours later)
Hi again:

I have been doing some research in Lyme disease. I also read up on Bell's palsy. I understand that I have XXXXXXX Hunt Syndrome Type 2. Would Lyme's disease have been more likely than Bell's palsy. I understand that the rash in my ear will heal up, but I did not develop the rash right away in the ear.

Thank you for your consideration to my question.
doctor
Answered by Dr. Sumit Bhatti (5 hours later)
Hi,

Thank you for writing back.

1. Bell's Palsy is the most common cause of idiopathic Facial Nerve Palsy. There is usually no rash in Bell's Palsy. There is usually complete recovery in cases of Bell's Palsy.

2. Lyme Disease is missed because there may be a long time between other symptoms and the Facial weakness. There are many causes of Facial nerve paralysis which should be ruled out.

3. Certain lectro-diagnostic tests are done routinely to assess the extent of damage to the Facial Nerve. This helps predict the recovery. NCS (Nerve Conduction Studies) and EMG (Electro Myo Graphy) are done between the 10th and 14th day following the onset of Facial nerve weakness. If EnoG (Electro Nystagmo Graphy) is available, it may be done. You may share the results here.

4. I my experience, the rash in XXXXXXX Hunt Syndrome Type 2 always appears after a few days. Initially the patient complains of ear ache. Especially when the ear is normal and there is no clinical sign on examination, I always explain to patients about the possibility of XXXXXXX Hunt Syndrome Type 2. Patients are instructed to follow up immediately on the first sign of facial heaviness, numbness or rash / vesicles. Otherwise many patients do not realize the onset of symptoms and follow up much later with full blown Facial Palsy.

5. Get a doctor to examine you. There are many points to be noted. For example, any facial Nerve Paralysis should be differentiated into LMN (Lower Moter Neuron) and UMN (Upper Motior Neuron) Palsy. In UMN Palsy, the forehead wrinkling is spared on the side of the paralysis whole in LMN Palsy, the entire half of the face including the forehead is paralyzed.

6. Hearing and acousitic reflex tests help determine the level of the nerve injury.

7. I hope that your medication and physiotherapy has been started.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (2 hours later)
Dr. Bhatti:

Thank you very much for all the information and answering all my questions in a way that is understandable. This has been a great conversation and very, very helpful. I really appreciate your help. Yes, I am on medication, just as you said, I needed, so I hope that I do not get the permanent problems that a delay in treatment would have caused.

This was my first time using this service, and I am very grateful for all your help.
doctor
Answered by Dr. Sumit Bhatti (9 hours later)
Hi,

Thank you for writing back.

1. Early detection and medication definitely helps in earlier and better recovery.

2. You may share your reports and progress here.

Wishing you a speedy recovery.

Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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Suffering From Ramsay Hunt Syndrome Type 2. Have Swollen Node Of Neck. Is This Same As Shingles?

Hi,

Thank you for your query.

1. XXXXXXX Hunt Syndrome Type 2 is the same as Shingles. Shingles refers to herpes zoster infecting any cutaneous nerve in the body while Herpes Zoster Oticus indicates involvement of the facial nerve (Seventh Cranial nerve)

2. Herpes zoster oticus also cause reduction in secretions. Scanty nasal secretions may be due to reflex dysfunction or infection spreading to the Trigeinal Nerve (Fifth Cranial nerve) via unnamed connecting branches.

3. The lymph nodes are swollen due to this infection and inflammation.

4. In my experience, a herpes reactivation many a times signifies some stress or weakness in the body which allows the dormant virus to surface again. Be sure to rule out Lyme Disease.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.