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Ramsay Hunt Syndrome

(Herpes Zoster Oticus)

Definition

Ramsay Hunt syndrome (RHS) is a problem moving the muscles on one side of the face. It also results in a rash around the ear or mouth. It is not common.

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Causes

RHS is caused by the varicella zoster virus (VZV). The virus is the same one that causes chickenpox and shingles. It stays in the body even after the illness has passed. In some people, it can reactivate and cause RHS.

Risk Factors

Things that may raise the risk of this problem are:

  • Having shingles or a history of chickenpox
  • A weakened immune system
  • Having other family members who have had shingles

Symptoms

Problems may be:

  • Painful, one-sided red rash in the ear, mouth, or on the tongue
  • Problems moving one side of the face, with or without a rash
  • Dry mouth and eyes
  • Loss of taste
  • Problems hearing
  • Ringing in the ear
  • Nausea or vomiting
  • A feeling of spinning while standing still
  • Eyes that move without control

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done. This is often enough to make the diagnosis.

Lab tests may need to be done to confirm a diagnosis that is not certain.

Treatment

The goal of treatment is to ease discomfort and quicken recovery. Choices are:

  • Antiviral medicine to shorten the length of time of the infection if taken early
  • Corticosteroids to ease inflammation
  • Benzodiazepines to ease the feeling of spinning
  • Pain medicine

Prevention

This risk of this problem may be lowered by getting the herpes zoster vaccine.

RESOURCES:

National Institute of Neurological Diseases and Stroke
http://www.ninds.nih.gov

National Organization for Rare Disorders
https://rarediseases.org

CANADIAN RESOURCES:

Canadian Neurological Sciences Federation
http://www.cnsfederation.org

Health Canada
https://www.canada.ca

REFERENCES:

About shingles (herpes zoster). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/shingles/about/index.html. Accessed January 12, 2021.

Herpes zoster. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/herpes-zoster. Accessed January 12, 2021.

NINDS herpes zoster oticus information page. National Institute of Neurological Diseases and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Herpes-Zoster-Oticus-Information-Page. Accessed January 12, 2021.

Schmader K. Herpes Zoster. Ann Intern Med. 2018 Aug 7;169(3):ITC19-ITC31.

Last reviewed December 2020 by EBSCO Medical Review Board Rimas Lukas, MD  Last Updated: 1/12/2021