Ramsay Hunt syndrome: What is it?

Recently, Canadian singer Justin Bieber took to Instagram to reveal that he was suffering from partial paralysis of the face due to Ramsay Hunt Syndrome. Actress, Angelina Jolie was diagnosed with Bell’s palsy in 2016 and opened up about her battle with facial paralysis. She has since fully recovered with the help of acupuncture. Katie Holmes, the former Mrs. Tom Cruise, and actress from Dawson’s Creek was also a victim of facial paralysis. It is thought the residual effects of Bell’s palsy are responsible for her classic facial smirk.


Ramsay Hunt syndrome (RHS) is a rare neurological disorder characterized by paralysis of the facial nerve (facial palsy) and a rash affecting the ear or mouth. Ear abnormalities such as ringing in the ears (tinnitus) and hearing loss may also be present.

Ramsay Hunt syndrome is caused by the varicella zoster virus (VZV), the same virus that causes chickenpox in children and shingles (herpes zoster) in adults. Anyone who has had chickenpox can potentially develop Ramsay Hunt syndrome. However, most cases affect older adults, especially those over 60. Ramsay Hunt syndrome affecting children is extremely rare.

Symptoms of Ramsay Hunt syndrome (RHS)


The two main signs and symptoms of Ramsay Hunt syndrome are:

  • A painful red rash with fluid-filled blisters on, in, and around one ear
  • Facial weakness or paralysis on the same side as the affected ear

Usually, the rash and the facial paralysis occur at the same time. Sometimes one can happen before the other. Other times, the rash never occurs.

If you have Ramsay Hunt syndrome, you might also experience:

  • Ear pain
  • Hearing loss
  • Ringing in your ears (tinnitus)
  • Difficulty closing one eye
  • A sensation of spinning or moving (vertigo)
  • A change in taste perception or loss of taste
  • Dry mouth and eyes

Risk factors

Ramsay Hunt syndrome isn’t contagious. However, reactivation of the varicella-zoster virus can cause chickenpox in people who haven’t previously had chickenpox or been vaccinated for it. The infection can be serious for people who have immune system problems.

Until the rash blisters scab over, avoid physical contact with:

  • Anyone who’s never had chickenpox or who’s never had the chickenpox vaccine
  • Anyone who has a weak immune system
  • Newborns
  • Pregnant women

Treatment Options

The treatment of Ramsay Hunt syndrome commonly involves antiviral medications, like acyclovir or famciclovir, in conjunction with corticosteroids, like prednisone. Most authorities agree that beginning antiviral treatment within three days of onset appears to have the greatest benefit as prompt diagnosis and management seem to improve outcomes. Despite therapy, some degree of facial paralysis and hearing loss may become permanent in some cases.

Further treatment is directed towards specific symptoms that are apparent in each individual. This includes pain medication, carbamazepine, an anti-seizure medicine that may help reduce neuralgic pain, and vertigo suppressants like antihistamines and anticholinergics.

Individuals with Ramsay Hunt syndrome need to take special care to prevent corneal injury because the inability to properly close the eye can expose the cornea to abnormal drying and foreign body irritation. Artificial tears and lubricating ointments may be prescribed to protect the cornea.

Is Ramsay Hunt Syndrome Curable?

If there is not much damage to the nerve, you should get better completely within a few weeks. If damage is more severe, you may not fully recover, even after several months,” according to New York’s Mount Sinai Hospital.

Common causes of facial paralysis include:

  • Infection or inflammation of the facial nerve, including Bell’s palsy, Ramsay Hunt syndrome, Lyme disease, and meningitis
  • Trauma, including basal skull fractures and facial injuries
  • Diabetes mellitus
  • Tumors of the head, neck, and brain
  • Stroke
  • Birth trauma as a result of forceps delivery
  • Autoimmune diseases, such as multiple sclerosis (MS) and sarcoidosis

Ref: https://www.mayoclinic.org/


The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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