Ramsay Hunt Syndrome
Ramsay Hunt syndrome, or herpes zoster oticus, occurs when the varicella-zoster virus reactivates and spreads to the facial nerves near your inner ear. The varicella-zoster virus is the same virus that causes chickenpox and shingles (herpes zoster). Treatment for the condition may include medications including antivirals and corticosteroids.
Other Names of Ramsay Hunt Syndrome
Herpes zoster oticus
Ramsay Hunt syndrome type 2.
Causes of Ramsay Hunt Syndrome
Ramsay Hunt syndrome occurs when the varicella-zoster virus reactivates in the facial nerve, which is the cranial nerve that affects your face, tongue and inner ear.
The varicella-zoster virus is the same virus that causes chickenpox and shingles.
If you had chickenpox as a child, the virus can remain inactive (dormant) in your nerves for years.
Shingles occurs when the previously dormant varicella-zoster virus reactivates.
The virus travels down your nerve fibers into your skin, causing painful sores.
The virus sometimes develops into Ramsay Hunt syndrome, affecting your facial nerve.
Researchers aren’t sure why the virus sometimes involves the facial nerve.
Symptoms of Ramsay Hunt Syndrome
Painful rash on your eardrum, ear canal and earlobe.
Fluid-filled blisters in your ear canal and on the outside of your ear.
Rash on your tongue, throat and roof of your mouth on the affected side.
Severe ear pain.
Ringing in your ear (tinnitus).
Increased sensitivity to sounds (hyperacusis).
Hearing loss on one side.
Dry eyes and mouth.
Loss of sense of taste.
Social anxiety because of facial abnormalities.
Diagnosis of Ramsay Hunt Syndrome
Your healthcare provider will perform a physical exam to diagnose Ramsay Hunt syndrome.
They’ll ask you about your medical history and symptoms.
Your provider will look for a rash and signs of weakness in your face.
Diagnosis can be difficult because the symptoms of the condition don’t always develop at the same time.
Therefore, your provider may request a laboratory test to confirm the diagnosis.
They may collect a sample of your saliva, blood or fluid from a blister.
A pathologist will examine the sample under a microscope, looking for the varicella-zoster virus.
It isn’t necessary, but your provider may also request an imaging test called a magnetic resonance imaging (MRI) scan.
This test can give your provider proof that another condition or disorder isn’t causing your symptoms.
Treatment of Ramsay Hunt Syndrome
An antiviral medication to treat the infection or decrease symptoms, such as acyclovir or valacyclovir.
A corticosteroid to reduce inflammation of the nerve, such as prednisone.
A pain reliever to reduce pain.
A variety of possible medications to relieve symptoms of vertigo.
An anti-seizure medicine, such as carbamazepine, to treat persistent pain (postherpetic neuralgia).