Medicine:Ramsay Hunt syndrome type 1

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Ramsay Hunt syndrome type 1

Ramsay Hunt syndrome type 1 is a rare, degenerative, neurological disorder characterized by myoclonus epilepsy, intention tremor, progressive ataxia and occasionally cognitive impairment [1]

It has also been alternatively called dyssynergia cerebellaris myoclonica,[2][3] dyssynergia cerebellaris progressiva,[4] dentatorubral degeneration, or Ramsay Hunt cerebellar syndrome.

Presentation

Onset of symptoms usually occurs in early adulthood and is characterized by intention tremor, progressive ataxia, convulsions, and myoclonic epileptic jerks.[1] Tremors usually affect one extremity, primarily the upper limb, and eventually involve the entire voluntary motor system.[1] Overall, the lower extremity is usually disturbed less often than the upper extremity.[1] Additional features of the syndrome include: an unsteady gait, seizures, muscular hypotonia, reduced muscular coordination, asthenia, adiadochokinesia and errors with estimating range, direction, and force of voluntary movements.[1] Mental deterioration can, rarely, occur.[1]

Causes

Ramsay Hunt syndrome type 1 is caused by the impairment of a regulatory mechanism between cerebellar and brainstem nuclei and has been associated with a wide range of diseases, including Lafora disease, dentatorubropallidoluysian atrophy, and celiac disease.[5][6]

Diagnosis

The diagnosis of Ramsay Hunt syndrome type 1 is different to individual people with the syndrome.

Treatment

Treatment of Ramsay Hunt syndrome type 1 is specific to individual symptoms.[1] Myoclonus and seizures may be treated with drugs like valproate.[1] Some have described this condition as difficult to characterize.[7]

Eponym

It is named for James Ramsay Hunt[8] who first described a form of progressive cerebellar dyssynergia associated with myoclonic epilepsy in 1921.[1]

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 "National Institute of Neurological Disorders and Stroke". February 14, 2011. http://www.ninds.nih.gov/disorders/dyssynergia/dyssynergia.htm. 
  2. ↑ Hunt JR (1921). "Dyssynergia cerebellaris myoclonica—Primary atrophy of the dentate system: A contribution to the pathology and symptomatology of the cerebellum". Brain 44 (4): 490–538. doi:10.1093/brain/44.4.490. https://zenodo.org/record/1431658. 
  3. ↑ "Dyssynergia cerebellaris myoclonica (Ramsay Hunt syndrome): a condition unrelated to mitochondrial encephalomyopathies". Journal of Neurology, Neurosurgery, and Psychiatry 52 (2): 262–5. February 1989. doi:10.1136/jnnp.52.2.262. PMID 2703843. 
  4. ↑ Hunt JR (1914). "Dyssynergia cerebellaris progressiva: A chronic progressive form of cerebellar tremor". Brain 37 (2): 247–268. doi:10.1093/brain/37.2.247. https://zenodo.org/record/1431644. 
  5. ↑ "Ramsay Hunt syndrome and coeliac disease: a new association?". Movement Disorders 1 (3): 209–19. 1986. doi:10.1002/mds.870010306. PMID 3504245. 
  6. ↑ "CSF antigliadin antibodies and the Ramsay Hunt syndrome". Neurology 49 (4): 1131–3. 1997. doi:10.1212/wnl.49.4.1131. PMID 9339701. 
  7. ↑ "Ramsay Hunt syndrome: to bury or to praise". Journal of Neurology, Neurosurgery, and Psychiatry 53 (1): 89–90. January 1990. doi:10.1136/jnnp.53.1.89. PMID 2106013. 
  8. ↑ synd/2245 at Who Named It?

External links

Classification



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