Ramsay Hunt syndrome: Symptoms, causes, and treatments

Ramsay Hunt syndrome is an infection of a facial nerve. It is a neurological disorder in which the Varicella zoster virus infects specific nerves in the head. The condition is also known as Herpes zoster oticus.

The Varicella zoster virus can also cause chicken pox. People who have had chicken pox carry the dormant virus in their nerves. Some years later it may become active again, infecting the facial nerve, causing Ramsay Hunt syndrome.

The condition involves a painful rash and facial muscle weakness, which is sometimes confused with a stroke.

Ramsay Hunt syndrome is usually effectively treated, but some people may have permanent facial muscle weakness and hearing loss.

The risk of complications drops significantly with prompt and proper treatment. The longer the person has to wait for treatment, the smaller the chances of making a complete recovery.

The Office of Rare Diseases classifies Ramsay Hunt Syndrome as a rare disease, with an incidence of around 5 in every 100,000 people in the United States. Most doctors will never come across a case of Ramsay Hunt syndrome during their careers.


Herpes zoster
The Varicella zoster virus causes Ramsay Hunt syndrome.

Early treatment improves the chance of a complete recovery.

The doctor is likely to prescribe an antiviral medication, such as acyclovir (Zovirax), famciclovir (Famvir), or valacyclovir (Valtrex), as well as a corticosteroid for the swelling and pain. The patient may have to take diazepam (Valium) for the symptoms of vertigo.

If facial weakness persists after the completion of medical treatment, the physician may recommend physical therapy to help regain proper use of the facial muscles.

An injection into the upper eyelid of botulinum toxin type A, more commonly known as Botox, may help those who have trouble closing one eye. An eye patch may help protect the affected eye.

Patients may take from a few weeks to several months to recover from Ramsay Hunt syndrome. If treatment is delayed and nerve damage is severe, a full recovery is much less likely.

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Successful recovery from Ramsay Hunt syndrome is dependent on recognizing and treating symptoms in the first few days.

The best way to ensure the fullest possible recovery is to take the drugs acyclovir and prednisolone within 7 days of symptoms starting.

The damage caused by Ramsay Hunt syndrome is reversible.


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