By Penelope A. Domogo, MD
Ramsay Hunt syndrome, also known as herpes zoster oticus, is a condition that occurs when the varicella zoster virus reactivates in the facial nerve near one of your ears. This virus is the same virus that causes chicken pox. The theory of how this happens is that after you have chicken pox in childhood, the virus stays dormant in your nerves and much later, when you are an adult and when your immune system gets weak, the virus can reactivate causing illness. In the Ramsay Hunt syndrome, the virus is reactivated in the facial nerve. If the virus reactivates in other nerves, the condition is just termed “shingles”.
There are two facial nerves – one near the right ear and another near the left ear. This left facial nerve supplies the left side of your face and the right facial nerve supplies the right side of your face. Thankfully, this varicella zoster virus affects only one side. Based on this function, there are two main signs and symptoms of the Ramsay Hunt syndrome:
1. Painful red rashes with fluid-filled blisters (like chicken pox) on, in and around the ear, on the face or on the mouth. Sometimes, though, there are no rashes.
2. Facial weakness or paralysis on the same side as the rash. This causes one side of your mouth to droop so it could be mistaken for a stroke.
Other symptoms are ear pain, hearing loss, ringing in the ears, difficulty closing one eye, loss of taste, dry mouth and eyes.
The virus will go away on its own after it has run its course but it may leave some long-term complications like permanent hearing loss and facial weakness, eye damage caused by drying of the cornea, and post-infection nerve pain.
Since the cause is a virus, it will go away on its own after it has run its course. However, starting treatment within three days from the start of signs and symptoms may help prevent long-term complications. Treatment may include medicines like antivirals and corticosteroids.
One who has Ramsay Hunt syndrome should avoid physical contact with the following until the blisters scab over:
1. Anyone who never had chicken pox or did not get the chicken pox vaccine
2. Anyone with weak immune system like those on chemotherapy
3. Newborns
4. Pregnant
This is to avoid possible transmission of the virus. The blisters will scab over in about 7-10 days then usually disappear after 2-4 weeks, as with the other symptoms.
By the way, this condition “got its name when an American army officer and neurologist named James Ramsay Hunt first described the disorder in 1907.” (my.clevelandclinic.org)***
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“Dear friend, I pray that you may enjoy good health and that all may go well with you, even as your soul is getting along well.” 3 John 1:2
