Ramsay Hunt syndrome or Facial paralysis

Ramsay Hunt syndrome which is also known as Facial Paralysis now is highlighted when US Pop star Justin Bieber revealed about his issue and was Diagnosed with Facial Paralysis (Year 2022).

History and Overview:

  • The disease is named after James Ramsay Hunt (In the year 1872-1937), an American neurologist and army officer during World War I who described three separate syndromes, the maximum notable of which is “Ramsay Hunt syndrome,”.
  • Ramsay Hunt syndrome, also known as geniculate ganglion herpes zoster or herpes zoster oticus, is a late consequence of varicella-zoster virus (VZV) infection that causes inflammation of the geniculate ganglion of cranial nerve CVII.
  • When a shingles eruption affects the facial nerve near one of the patients’ ears, it’s known as “Ramsay Hunt syndrome (herpes zoster oticus)”. This syndrome can contain facial paralysis and hearing loss in the afflicted ear, in addition to the severe shingles outbreak.
  • The same virus that causes chickenpox origins for Ramsay Hunt syndrome. The virus remains in the patients’ nerves after chickenpox has been cured. It could be reawakened years later & harm facial nerves if this happens.
  • Ramsay Hunt syndrome could be treated early to lessen the risk of sequelae, such as irreversible facial muscle paralysis and hearing.


  • Ramsay Hunt syndrome has two main symptoms & signs:
    1. On, in, and around one ear, a majorly red rash with fluid-filled blisters.
    2. Facial weakness or paralysis on the similar side as the affected ear Rash and facial paralysis frequently happen at the same time.
  • It’s possible that one of them will happen first. In certain cases, the rash does not emerge at all.  Others,
    • Ear pain
    • Hearing loss
    • Ringing in your ears (tinnitus)
    • Difficulty closing one eyeVertigo: This is a sensation of spinning or moving
    • A modification in taste perception (Observation) or loss of tasteDry mouth and eyes

Risk factors:

  • Someone who has had a history of chickenpox can get Ramsay Hunt syndrome. It primarily affects people over the age of 60 and is more prevalent among the elderly.
  • In children, this syndrome is very rare.
  • It is not infectious to have this syndrome.
  • Reactivation of the virus, on the other hand, can induce chickenpox in persons who have never had chickenpox or been vaccinated against it.
  • For patients with immune system issues or compromised, the infection can be deadly.
  • Avoid physical connection with the following items until the rash boils and scabs over:
    • Someone who’s not ever had chickenpox or who’s never had the chickenpox vaccine.
    • Anybody who has a weak or compromised immune system
    • New-borns or infants
    • Pregnant women

Complications :

  • Permanent hearing loss and facial weakness 
  • Eye Damage
  • Postherpetic neuralgia: A shingles infection disturbs nerve fibres, resultant in this excruciating illness. The info sent by these nerve fibres become mixed-up and amplified, resulting in pain that can continue long after the other Ramsay Hunt syndrome signs and symptoms have vanished.  

Prevention :

  • Chickenpox vaccination is normally administered to children in recent years, significantly reducing the risk of infection with the virus. A shingles vaccine is also recommended for persons over the age of 50.

Treatment / Management

  • In most cases, herpes zoster is self-limiting. As a result, the treatment’s primary goals are to reduce the occurrence of late sequelae including spastic facial paralysis and postherpetic neuralgia.
  • Oral antivirals and steroids have been found in multiple studies to significantly reduce long-term problems.
  • However, it is unknown if these drugs reduce the duration or severity of acute symptoms. All three antiviral drugs, acyclovir, valacyclovir, and famciclovir, have been investigated and confirmed to be effective.  


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