Sympathetic contralateral vestibulopathy after unilateral zoster oticus |
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Authors: | Schulz P Arbusow V Strupp M Dieterich M Sautier W Brandt T |
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Affiliation: | Department of Neurology, Ludwig-Maximilians University Munich, Klinikum Grobetahadern, Marchioninistr. 23, D-81377 Munich, Germany. pschulz@nefo.med.uni-muenchen.de |
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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. |
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