耳帯状疱疹出現後に脳幹障害をきたした症例—その神経耳科学的考察

Herpes Zoster Oticus Accompanied with Brainstem Disorder: A Neurotological Consideration

I．はじめに

　Ramsay Hunt症候群は，顔面神経麻痺，耳帯状疱疹，蝸牛・前庭症状の3主徴を有する定型的なものが最も多いが，耳帯状疱疹に前庭症状のみを伴い，顔面神経麻痺を欠くものは比較的稀である。今回我々は，耳帯状疱疹出現後，主にめまい，平衡障害をきたし，しかもその責任病巣として脳幹が示唆された症例を経験したので若干の文献的考察を加えて報告する。

　A case of herpes zoster oticus without facial palsy was presented in which the brainstem involvement was suspected by neurotological examinations.

　A 21-year-old female complained of severe vertigo with nausea about 4 weeks after the onset of herpes zoster oticus. Spontaneous horizontal nystagmus to the left (affected side of the auricle) persisted for about 2 weeks. The right beating optokinetic nystagmus was defective and the tracking test showed socalled unilateral saccadic pursuit to the left.

　These findings suggested that the spontaneous horizontal nystagmus observed in this case was due to brainstem lesion especially l-PPRF.