What is Ramsay Hunt Syndrome?
Ramsay-Hunt syndrome is a condition that can occur when the varicella zoster virus reactivates in the nervous system. This reactivation can cause a wide range of symptoms, including paralysis on one side of the face, rash, and pain. Ramsay-Hunt syndrome can be very serious, but fortunately it is relatively rare. This article will show you even more details about this infection.
Why does the shingles virus (VZV) reactivate?
Stress is often a trigger. Numerous studies have shown that stress can weaken the immune system and that people under severe stress are more likely to suffer from infections than those who are not. For this reason, it is thought that stress may be associated with shingles flare-ups and thus with SRH.
What are the symptoms of Ramsay-Hunt syndrome?
- A rash or blisters in or around the ear, scalp or hairline. Blisters can also appear inside the mouth.
- The rash/blisters are usually painful with an overall burning sensation in the affected area.
- Weakness on the affected side of the face that causes the facial muscles to droop.
- Difficulty closing the eye or blinking on the affected side.
- Change in taste on the affected half of the tongue.
- Loss of facial expression on the affected side.
- Difficulty eating, drinking and speaking due to weakness of the lip and cheeks on the affected side.
- Pain in the ear, face or head.
- Hearing loss on the affected side
- Tinnitus (ringing in the ears) on the affected side.
- In some cases, the throat can also be directly or indirectly affected by the vagus nerve.
Can you catch Ramsay-Hunt syndrome (RHS) from an infected person?
You cannot catch SRH from an infected person. People who are not immune to chickenpox can get chickenpox from a rash or open blister in someone with HRS.
How is Ramsay-Hunt syndrome diagnosed?
Diagnosis is often difficult because symptoms vary from person to person and the symptoms of SRH are similar to those of other forms of facial weakness. Patients with HRS may experience severe pain, which often helps differentiate it from other causes of sudden facial paralysis. The following tests and examinations can be used to diagnose HRS:
- A thorough history of your general practitioner.
- Examination of the function of the facial nerve (e.g. eye closure).
- Complete physical examination including ear examination.
- Blood tests to measure the presence of antibodies against the varicella-zoster virus that causes HRS.
- Hearing tests.
- Magnetic resonance imaging (MRI) to identify areas of inflammation along the path of the facial nerve and rule out any other causes of your symptoms.
Nerve conduction studies can assess facial nerve function. It is not a diagnosis, but indicates the degree of damage to the facial nerve.
Electromyography can also show if the facial nerve is damaged, but again cannot make a specific diagnosis or determine the reason for the damage.
What is the treatment for Ramsay-Hunt syndrome?
- Timely treatment (ideally within three days of the onset of symptoms) with an antiviral drug.
- Otherwise, immediate treatment with a short course of high-dose steroids is recommended.
- Blink Free Eye Lubricant (preservative free if used more than four times a day).
What healing can we expect?
- If antiviral treatment is given within 72 hours of the onset of symptoms, nearly 70% of patients recover almost completely from the infection.
- If the antiviral is not given during this time, the chance of a full recovery is reduced to 50%.
- The more severe the damage, the longer it takes to recover and the lower the chance of returning to normal function.
- If the nerve damage is mild, healing should occur within a few weeks.
- Recovery is similar to Bell’s palsy. However, the symptoms of Ramsay-Hunt syndrome tend to be more severe than those of Bell’s palsy.
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