Sympathetic contralateral vestibulopathy after unilateral zoster oticus

A unique case of initially right sided varicella tester induced Ramsay-Hunt syndrome with complete vestibular loss is reported. The patient subsequent ly developed deficits of the left vestibule 5 months later. An autoimmune p athogenesis of the left vestibular failure rather than bilateral varicella tester infection was suggested by the following data: (1) no evidence of ve sicular eruptions on the left auricle and the virtual absence of antiviral antibodies after onset of bilateral vestibulopathy; (2) prompt response of the left vestibule to immmunosuppressive therapy with corticosteroids; and (3) presence of atypical nervous tissue specific autoantibodies against a 4 5 kDa protein.