Preliminary Diagnosis: Ramsay-Hunt Syndrome

I. What imaging technique is first-line for this diagnosis?

  • 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.

  • Highly specific and sensitive to evaluate for any specific brain parenchymal and/or cranial nerve abnormality and abnormal enhancement.

  • MR imaging with IAC protocol offers detail of the bilateral inner ears and associated cranial nerves and solid structures.

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  • Expensive.

  • Time consuming.

  • 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?

  • No alternative imaging techniques exist.