A 60 year old male presents with a 2 day history of a severe left ear ache with a burning sensation in the ear and loss of taste. There is left sided weakness of both upper and lower facial muscles. Facial sensation is normal. A few vesicles are seen in the pharynx. What is the most likely diagnosis ?
Correct answer: D. Ramsay Hunt syndrome
- A. Bell's palsy
- B. Acoustic neuroma
- C. Diphtheria
- D. Ramsay Hunt syndrome
Explanation
Ramsay Hunt syndrome is reactivation of varicella-zoster virus in the geniculate ganglion, causing severe ear pain, vesicles in the ear or oral pharynx, loss of taste, and ipsilateral upper and lower facial paralysis. Bell palsy causes facial weakness but does not typically produce vesicles or severe otalgia.
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