SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Neuroinfectious Diseases
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1509110
Varicella-Zoster Virus Vasculopathy: A Rare Complication of Ramsay Hunt Syndrome; A Literature Review
Provisionally accepted
Mian Song*
Di Wu- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
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Background: Ramsay Hunt Syndrome TypeⅡ(RHSⅡ), also known as herpes zoster oticus, is an example of reactivation of the varicella-zoster virus (VZV) at the geniculate ganglion. Although rare, reports of VZV vasculopathy secondary to RHSⅡ have been documented. The aim of this review was to analyze clinical and neuroimaging findings, laboratory findings, treatment and outcome of these patients.We report a literature review that includes all case reports identified via PubMed on RHSⅡ complicated by VZV Vasculopathy. All epidemiological, clinical, imaging, virologic, treatment and outcome data collected are described.We analyzed a total of RHSⅡ complicated by VZV vasculopathy 9 cases (median age 54.0±16.5 years, range 24-75), and 22.2% (2/9) were immunocompromised. Apart from RHSⅡ-related symptoms, the most common symptom is cranial nerve injury (77.8%,7/9). Abnormal brain imaging in 88.9% (8/9), including 8 cases of ischemic stroke and one of which was accompanied by hemorrhagic stroke. Vascular studies revealing abnormalities in 66.7% (6/9) cases. Cerebrospinal fluid (CSF) analysis revealed 5 (55.6%, 5/9) cases were positive for VZV IgG, and 5 (55.6%, 5/9) cases tested positive for VZV DNA. All 9 patients received acyclovir treatment, with 77.8% (7/9) combination with corticosteroids.A favorable outcome was observed in 88.9% (8/9) of the patients. We analyzed a total of 9 cases of RHS II complicated by VZV vasculopathy.
Keywords: Ramsay Hunt syndrome, Herpes Zoster Oticus, varicella zoster virus, Stroke, VZV vasculopathy Ramsay Hunt Syndrome, VZV vasculopathy
Received: 10 Oct 2024; Accepted: 04 Jun 2025.
Copyright: © 2025 Song and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mian Song, Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
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