Neurology: Ramsay Hunt syndrome treatment: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Neurology: Ramsay Hunt syndrome treatment

Sample item

A 60-year-old man has severe left ear pain followed by vesicles in the external auditory canal, left facial weakness involving the forehead, vertigo and hearing loss. What is the most appropriate treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Oral aciclovir or valaciclovir with prednisolone

Ramsay Hunt syndrome is reactivation of varicella-zoster virus in the geniculate ganglion. Early antiviral therapy combined with corticosteroids improves the chance of facial nerve recovery, which is poorer than in Bell palsy.

Option by option

  • A. Prednisolone alone

    Steroids alone ignore the viral cause and give inferior recovery.

  • B. Intravenous ceftriaxone

    Ceftriaxone treats bacterial infection and has no effect on zoster.

  • C. Oral aciclovir or valaciclovir with prednisolone (correct)

    Correct. Antiviral therapy plus corticosteroids is standard.

  • D. Surgical decompression of the facial nerve

    Surgery is not indicated in the acute viral syndrome.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Oral aciclovir or valaciclovir with prednisolone. Ramsay Hunt syndrome is reactivation of varicella-zoster virus in the geniculate ganglion.

Why is "Prednisolone alone" not the answer?

Steroids alone ignore the viral cause and give inferior recovery.

Why is "Intravenous ceftriaxone" not the answer?

Ceftriaxone treats bacterial infection and has no effect on zoster.

Why is "Surgical decompression of the facial nerve" not the answer?

Surgery is not indicated in the acute viral syndrome.

What concept does this question test?

It tests Neurology: Ramsay Hunt syndrome treatment in General Medicine. Early antiviral therapy combined with corticosteroids improves the chance of facial nerve recovery, which is poorer than in Bell palsy.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neurology: Ramsay Hunt syndrome treatment?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.