Preliminary Diagnosis: Ramsay-Hunt Syndrome
I. What imaging technique is first-line for this diagnosis?
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MR of the brain and full bilateral Internal Auditory Canals (IAC) with contrast.
II. Describe the advantages and disadvantages of this technique for diagnosing Ramsay-Hunt syndrome.
Advantages
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Highly specific and sensitive to evaluate for any specific brain parenchymal and/or cranial nerve abnormality and abnormal enhancement.
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MR imaging with IAC protocol offers detail of the bilateral inner ears and associated cranial nerves and solid structures.
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Disadvantages
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Expensive.
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Time consuming.
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Requires significant patient cooperation to minimize motion artifact.
III. What are the contraindications for the first-line imaging technique?
Contraindicated in patients with non–MR compatible hardware.
Gadolinium contrast is contraindicated in patients with a GFR ≤ 30.
IV. What alternative imaging techniques are available?
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No alternative imaging techniques exist.
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