Ramsey Hunt Syndrome: What You Need to Know

Ramsey Hunt Syndrome

Ramsey Hunt syndrome is a viral infection that affects the nerves of the face and ear.

The infection is caused by the varicella-zoster virus, which is the same virus that causes chickenpox.

The syndrome gets its name from Dr. Ramsey Hunt, who first described it in 1907.

According to the National Organization for Rare Disorders, Ramsey Hunt syndrome is relatively rare, affecting about 5 in 100,000 people in the United States. (1)

Some people can confuse Ramsay Hunt syndrome with Bell’s Palsy.

Why does it occur?

According to the Mayo Clinic, the varicella-zoster virus lies dormant in the nervous system after a person has chickenpox.

For reasons that are not fully understood, the virus can reactivate later in life and cause Ramsey Hunt syndrome. (2)

Who is at risk?

Anyone who has had chickenpox is at risk of developing Ramsey Hunt syndrome.

However, the risk is higher in people with weakened immune systems, such as those with HIV/AIDS or cancer.

Also, pregnant women and newborns are at higher risk of developing the syndrome.  (3)

What are the symptoms?

The most common symptom of Ramsey Hunt syndrome is a painful rash on one side of the face.

The rash usually appears around the ear and can often spread to the eye, causing swelling and redness.

Other symptoms include:

  • Facial weakness or paralysis
  • Hearing loss
  • Ringing in the ear (tinnitus)
  • Vertigo (a sensation of spinning)
  • Change in taste sensation or loss of taste
  • Painful blisters in the mouth or on the tongue (herpes zoster, shingles in the mouth)
  • Trouble closing the eye on the affected side
  • Pain when moving the affected ear
  • Dry mouth and eyes
  • Nausea and vomiting

The symptoms of Ramsey Hunt syndrome can range from mild to severe.

In some cases, the virus can cause permanent damage to the facial nerve. (4, 5)

Ramsey Hunt Syndrome: What You Need to Know

How is it diagnosed?

Ramsey Hunt syndrome is typically diagnosed based on the symptoms.

Your doctor may also order a blood test to look for antibodies to the varicella-zoster virus.

In some cases, an MRI or CT scan may be ordered to rule out other conditions

How is Ramsey Hunt syndrome treated?

The goal of treatment is to reduce the pain and other symptoms.

Treatment options include:

  • Pain relievers: Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin IB) and acetaminophen (Tylenol), can help ease the pain of the rash.
  • Anti-viral medications: These medications, such as valacyclovir (Valtrex) and famciclovir (Famvir), can help shorten the duration of the rash and speed healing.
  • Corticosteroids: These medications, such as prednisone, can help reduce swelling and pain.

They are typically only used for people with severe symptoms.

  • Treatment for hearing loss: If you have hearing loss, your doctor may recommend a hearing aid or other devices to help amplify sound.
  • Treatment for facial paralysis: If you have facial paralysis, the doctor may recommend physical therapy to help retrain the muscles of your face. In some cases, surgery may be needed to correct the problem. (6)

What are the complications?

The most common complication of Ramsey Hunt syndrome is hearing loss.

Other complications include:

  • Facial paralysis
  • Tongue paralysis
  • Eye problems, such as corneal ulcers
  • Permanent damage to the facial nerve

What is the outlook?

The outlook for people with Ramsey Hunt syndrome varies depending on the severity of the condition.

In most cases, the symptoms will improve with treatment and there will be no long-term effects.

However, in some cases, the condition can cause permanent damage.

If you think you or your child may have Ramsey Hunt syndrome, it is important to see a doctor right away.

Early diagnosis and treatment can help improve the outlook and reduce the risk of complications.