Ramsay Hunt Syndrome with Multiple Cranial Neuropathies: Role of Pulse Steroid Therapy with Newer Antiviral Agent in Nonresponding Hiccoughs and Laryngeal Palsy.

Ramsay hunt syndrome (RHS) is characterised by herpetic blisters (small vesicles) of the skin of the external canal, pinna and/or the oral mucosa and severe otalgia (ear pain) along with acute peripheral facial paralysis and/or vestibulocochlear dysfunction (e.g., vertigo, hearing loss, hyperacusis, tinnitus). RHS with multiple cranial neuropathies is rare, more severe, and usually intractable. A combination therapy of antiviral agents and steroids is the preferred treatment. We present a case of 30-year-old man suffering from RHS with multiple cranial neuropathies treated effectively with combination therapy of intravenous pulse steroid therapy and newer antiviral agent for intractable hiccoughs and laryngeal palsy.