Ramsay Hunt Syndrome | Otolaryngology (ENT) | Loyola Medicine

Ramsay Hunt Syndrome

Overview and Facts about Ramsay Hunt Syndrome

Ramsay Hunt syndrome is a facial nerve disorder in which shingles (varicella zoster virus) affects the facial nerve and other cranial nerves on one side of the face. It is caused by the same virus as chickenpox, appears as a painful rash, and can result in facial paralysis and hearing loss. If you have had chickenpox, the virus lays dormant along the nerve ganglions (nerve cell clusters). When the virus reactivates, Ramsay Hunt syndrome can be the result.

Symptoms and Signs of Ramsay Hunt Syndrome

A painful rash and facial paralysis on one side of the face are the main signs of Ramsay Hunt syndrome. Pain typically precedes the rash by several hours to days. The rash usually begins around the affected ear as red blisters. Complete or partial facial paralysis often occurs after the rash has erupted. 

In addition, other symptoms include:

  • Decreased ability to taste
  • Difficulty hearing from the affected ear
  • Ear pain
  • Vertigo
  • Tinnitus (ringing in the ears)
  • Dry eyes and mouth
  • Eye irritation or pain

If you notice any of the above signs, it is important to see your doctor right away, as prompt treatment is key to preventing long-term complications, including permanent facial weakness, hearing loss, eye damage and post-herpetic neuralgia (painful damage to nerve fibers). 

Causes and Risk Factors of Ramsay Hunt Syndrome

Patients who have had chickenpox in the past can develop shingles and Ramsay Hunt syndrome. The virus from chickenpox can lay dormant in the body, reappearing as shingles later in life. Those at a higher risk include patients over 60 or those with weakened immune systems. The virus that causes Ramsay Hunt syndrome is contagious and may cause others you come in contact with to contract chickenpox when symptoms are present (if they have never had or been vaccinated for chickenpox). You should also avoid contact with infants and pregnant women until you have been successfully treated for Ramsay Hunt syndrome. 

Tests and Diagnosis of Ramsay Hunt Syndrome

Your doctor will be able to visually assess your symptoms to determine if you have Ramsay Hunt syndrome. He/she will also conduct a thorough physical exam and review your medical history to check if you have had a chickenpox vaccination. If necessary, he/she will also take a fluid sample from a rash blister for laboratory testing to confirm diagnosis. A hearing test (audiogram) may be done to assess the level of hearing loss.  

Treatment and Care for Ramsay Hunt Syndrome

Together, you and your Loyola doctor will determine the best course of treatment for your condition. Your doctor is primarily concerned with improving your quality of life so that you may return to your normal activities. At Loyola, you have access to the most advanced treatments available for facial paralysis. 

Prompt treatment is important as it prevents long-term complications, such as permanent hearing loss and facial paralysis. Treatment for Ramsay Hunt syndrome includes:

  • Corticosteroids (prednisone)
  • Antiviral drugs (Valtrex)
  • Anti-anxiety medications for vertigo relief
  • Pain relievers and anti-inflammatory drugs (Ibuprofen, Advil, etc.)
  • Eye care
  • Facial nerve decompression with or without electrical stimulation

You can also practice self-care techniques, such as keeping the area clean and cooling with a wet compress to relieve any pain. 

Prevention of Ramsay Hunt Syndrome

Vaccinations for chickenpox (for children) and for shingles (for adults over 60) greatly reduce your chance of developing Ramsay Hunt syndrome.