Long-Term MRI Signal Change in the Spinal Trigeminal Nucleus and Tract After Ramsay Hunt Syndrome and Trigeminal Herpes Zoster

Ramsay Hunt syndrome is a rare neurologic disorder caused by varicella zoster virus (VZV). The association with trigeminal herpes zoster is rare and only a few cases have been reported in the literature. We report a case of a VZV infection affecting first the glossopharyngeal nerve before subsequently causing Ramsay Hunt syndrome, trigeminal herpes zoster, VIII cranial nerve neuropathy, C2 neuropathy, and postherpetic neuralgia. MR imaging-signal intensity‐intensity abnormalities were seen and followed in the spinal trigeminal nucleus and tract (STNT).