Vesicle in ear with facial nerve palsy on same side is due to which in infection-

Ans. is 'b' i.e., VZVRamsay Hunt syndromeo It is lower motor neuron type offacial palsy due to Varicella (herpes) zoster. Pain is often a prominent feature and vesicles are seen in the ipsilateral ear, on the hard palate and/or on anterior two third of tongue. It may involve other cranial nerves-V, VIII, IX and X and cervical branches (C2, C3 & C4) that have anastomotic communications with facial nerve. This results in features like:# Anaesthesia of face# Giddiness# Hearing impairment along with VII nerve palsy.o The mechanism of disease is reactivation of the latent varicella zoster virus in the geniculate ganglion. The onset of palsy is preceeded by pain which may persist & become excruciating. When the rash is absent it is known as zoster sine herpete.o The prognosis of Ramsay Hunt syndrome is worse than Bells palsy. Persistent weakness is observed in 30-50% of patients and only 10% recover completely after complete loss of function without treatment.o Treatment recommended is prednisone (steroid) combined with acyclvir.