What is Ramsay Hunt syndrome?
Ramsay Hunt syndrome (herpes zoster oticus) occurs when a shingles outbreak affects the facial nerve near one of your ears. In addition to the painful shingles rash, Ramsay Hunt syndrome can cause facial paralysis and hearing loss in the affected ear.
Ramsay Hunt syndrome is caused by the same virus that causes chickenpox. After chickenpox clears, the virus lies dormant in your nerves. Years later, it may reactivate. If the virus reactivates and affects your facial nerve, the result is Ramsay Hunt syndrome.
Prompt treatment of Ramsay Hunt syndrome can reduce your risk of complications, which can include permanent facial muscle weakness and deafness.
How common is Ramsay Hunt syndrome?
Ramsay Hunt syndrome can affect patients at any age. Please discuss with your doctor for further information.
What are the symptoms of Ramsay Hunt syndrome?
The common 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 develop at the same time. But in some cases, the rash will occur before the facial paralysis or the paralysis before the rash. Sometimes the rash never materializes.
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
Complications of Ramsay Hunt syndrome may include:
- Permanent hearing loss and facial weakness. For most people, the hearing loss and facial paralysis associated with Ramsay Hunt syndrome is temporary. However, it can become permanent for some people.
- Eye damage. The facial weakness caused by Ramsay Hunt syndrome may make it difficult for you to close your eyelid. Incomplete eyelid closure can lead to damage of the protective dome of clear tissue over the front of your eye (cornea). This damage can cause eye pain and blurred vision.
- Postherpetic neuralgia. This painful condition occurs when a shingles infection damages nerve fibers. The messages sent by these nerve fibers become confused and exaggerated — causing pain that may persist long after other signs and symptoms of Ramsay Hunt syndrome have faded.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
Call your doctor if you experience facial paralysis or a shingles rash on your face. Treatment beginning within three days of the start of signs and symptoms may help prevent long-term complications.
What causes Ramsay Hunt syndrome?
Ramsay Hunt syndrome occurs in people who’ve had chickenpox. Once you recover from chickenpox, that virus can lie dormant in your body for years — sometimes reactivating in later years to cause shingles, a painful rash with fluid-filled blisters.
Ramsay Hunt syndrome is a shingles outbreak that affects the facial nerve near one of your ears. It typically also causes varying degrees of one-sided facial paralysis and hearing loss.
What increases my risk for Ramsay Hunt syndrome?
There are many risk factors for this condition, such as:
- A history of chickenpox
- Age: It’s more common in older adults, typically affecting people older than 60.Ramsay Hunt syndrome is rare in children.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is Ramsay Hunt syndrome diagnosed?
Doctors often can identify Ramsay Hunt syndrome based on medical history, a physical exam and the disorder’s distinctive signs and symptoms. To confirm the diagnosis, your doctor might take a sample of fluid from one of the rash blisters in your ear for testing.
How is Ramsay Hunt syndrome treated?
Prompt treatment of Ramsay Hunt syndrome can ease pain and decrease your risk of long-term complications. Medications may include:
- Antiviral drugs. Medications such as acyclovir (Zovirax), famciclovir (Famvir) or valacyclovir (Valtrex) often help combat the chickenpox virus.
- Corticosteroids. A short regimen of high-dose prednisone appears to boost the effect of antiviral drugs in Ramsay Hunt syndrome.
- Anti-anxiety medications. Drugs such as diazepam (Valium) can help relieve vertigo.
- Pain relievers. The pain associated with Ramsay Hunt syndrome can be severe. Prescription pain medications may be needed.
Lifestyle changes & Home remedies
What are some lifestyle changes or home remedies that can help me manage Ramsay Hunt syndrome?
The following lifestyles and home remedies might help you cope with Ramsay Hunt Syndrome:
- Keep areas affected by the rash clean.
- Apply cool, wet compresses to the rash to ease pain.
- Take an over-the-counter pain reliever or anti-inflammatory drug, such as ibuprofen (Advil, Motrin IB, others).
If facial weakness makes it difficult for you to close one of your eyes, take the following steps to protect your vision:
- Use moisturizing eyedrops throughout the day if your eye becomes dry.
- At night, apply ointment to the eye and tape your eyelid shut or wear an eye patch.
Children are now routinely vaccinated against chickenpox, which greatly reduces the chances of them becoming infected with the naturally occurring chickenpox virus. A shingles vaccine for people age 60 or older also is recommended
If you have any questions, please consult with your doctor to better understand the best solution for you.
- Ramsay Hunt syndrome. http://www.mayoclinic.org/diseases-conditions/ramsay-hunt-syndrome/home/ovc-20257238. Accessed 13 Feb 2017
- Ramsay Hunt Syndrome. http://emedicine.medscape.com/article/1166804-overview. Accessed 13 Feb 2017
- Ramsay Hunt Syndrome. http://www.medicinenet.com/ramsay_hunt_syndrome/article.htm. Accessed 13 Feb 2017
Review Date: September 5, 2017 | Last Modified: September 5, 2017