Herpes Zoster Oticus without Facial Palsy and Hearing Loss Masquerading as Vestibular Neuritis

ABSTRACT

Herpes zoster oticus, also called Ramsay-Hunt syndrome, involves the geniculate ganglion and presents with facial nerve palsy, sensorineural hearing loss, vestibular dysfunction, and auricular vesicular lesion. In this case, the patient presented with isolated vestibular dysfunctions without facial palsy and hearing impairment, and these findings were confirmed by electrophysiologic studies including video head impulse testing. Clinicians should be aware of this variation, and differentiate it from vestibular neuritis which usually does not require intensive antiviral therapies.