Ramsay Hunt Syndrome

*What is Ramsay Hunt Syndrome?*

Ramsay Hunt Syndrome is an infection of your facial nerve, which is also known as the 7th cranial nerve. It is caused from the varicella-zoster virus, which is the same virus that causes chicken pox. Once you have had the chicken pox, the virus lies dormant in your nervous system. If the virus is not destroyed after the initial infection, chicken pox, it can return and affect your facial nerve, Ramsay Hunt Syndrome, or it can cause other disorders including shingles. Anyone who has had chicken pox can have this disorder, but it is most commonly seen in people over 60. It is very rare for this to occur in children. This disorder is not contagious, although the reactivation of the varicella-zoster virus can cause chicken pox in individuals that have not previously had them.

*Symptoms*

A classic symptom of Ramsay Hunt Syndrome is a painful red rash with fluid-filled blisters. These can occur in various places including the outside of your ear, the roof of your mouth, your eardrum, your external ear canal, or on your tongue. People who experience the onset of this disorder tend to think they are having a stroke because facial weakness and paralysis is another common effect. Other symptoms are ear pain, hearing loss, vertigo, ringing in the affected ear(tinnitus), and difficulty closing one eye.

This is a picture of an individual with facial weakness from experiencing Ramsay Hunt Syndrome.

http://www.mayoclinic.com/health/ramsay-hunt-syndrome/DS00878/DSECTION=symptoms

*Diagnosis*

Ramsay Hunt Syndrome is diagnosed by a medical history evaluation and a physical exam. The doctor may also draw fluid from the blisters to confirm the diagnosis.

*Treatment*

The treatment for Ramsay Hunt Syndrome is an antiviral medication, among other medicines for the other things this disorder causes. Therapy may be prescribed to help regain control of the facial muscles. Recovery may take anywhere from several weeks to several months, but if the reaction is severe, full recovery may not be possible.

These are both MRI images with one taken before Gadolinium and one taken after Gadolinium. Notice the enhancement of the cranial nerves on the right side. This, along with the symptoms of the patient, led to the diagnosis of Ramsay Hunt Syndrome.

http://home.flash.net/~drrad/tf/052796a.jpg

Epilepsy

The reason I chose this pathology is because my boyfriend's younger brother was just recently diagnosed with this. I wanted to research it and find out more information on what this actual is. 

*What is Epilepsy?*

Epilepsy is a fairly common disease that affects the nervous system and occurs in about 2.5 million Americans. It is most commonly seen affecting children and teens with about 180,000 diagnosed every year. 

The brain is run by electrical signals. When these signals misfire, there is a temporary communication problem between nerve cells. Some of the things that can lead to epilepsy are brain injuries, brain tumors, lack of oxygen during birth, and an infection or illness the fetus acquires during pregnancy. 

 

*Symptoms* 

The most common symptom of epilepsy is seizures, but not everyone that has seizures has epilepsy. Seizures can occur in anyone under certain conditions, but epilepsy is characterized by repeated seizures. They are typically the same type of seizure each time they occur, so the affected person will probably act similar during each one. When a seizure occurs the person can lose consciousness, become unaware of what is going on around them, or have involuntary motions, among other things. This will leave the person very weak and very tired. My boyfriend's brother has a couple different strengths of seizures. Sometimes he will be going upstairs to brush his teeth and stop halfway there. His mom will go to check on him a couple minutes later and find him standing in the hallway and she will ask him what he is doing. Most times he has no idea what he was supposed to be doing, so his mom has to remind him that he was supposed to be going to brush his teeth. Other times his seizure is stronger. This usually leaves him extremely tired and causes him to miss school for the day.

*Treatment*

There are a few ways in which doctors can treat this disease. The most common way is through medication to control seizures. The medication won't make the seizures stop, but they usually fade out or even disappear as the child gets older. Another way is to implant a Vagus Nerve Stimulator underneath the skin in the chest. A wire is run up through the neck where it attaches to the vagus nerve. This device stimulates the nerve to reduce seizure frequency and intensity. If the person has partial seizures, a third treatment is surgery to remove the part of the brain where the seizures occur.

As we are all aware, this is a T2 weighted MRI image of a normal brain.

http://www.indianradiologist.com/neuroradiology24.htm

This is a T2 weighted MRI image of a 3-year-old with right sided hemimegalencephaly, enlargement of one side of the brain, which leads to seizures.

http://www.childrensmemorial.org/cme/online/article.asp?articleID=103