(Herpes Zoster Oticus)
Ramsay Hunt syndrome is a combination of symptoms caused by the shingles virus
. The virus infects a specific set of nerves that affect the ear, mouth, skin, and muscles of the face, neck, and scalp. The shingles virus is the same virus that causes chickenpox
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The chickenpox virus remains in the body, even after the illness has passed. In some, this virus can reactivate and cause shingles, an infection that causes inflammation along certain nerves.
With Ramsay Hunt, the infection affects a specific set of facial nerves that can affect the ear, mouth, face, neck, and scalp.
Factors that may increase your risk of Ramsay Hunt syndrome include:
- Having shingles or history of chickenpox
- Weakened immune system
- Family history of shingles
Ramsay Hunt syndrome may cause:
- Painful, one-sided red rash in the ear, mouth, or on the tongue
- One-sided facial paralysis, with or without a rash—Bell’s palsy
- Dry mouth and/or eyes
- Loss of taste
- Hearing loss
- Ringing in the ear—tinnitus
- Nausea or vomiting
- Involuntary eye movement—nystagmus
Your doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor can often make the diagnosis based on history and physical exam.
Your doctor may want lab tests to confirm shingles or identify other infectious causes.
Treatment for milder symptoms is usually not needed. For moderate or severe symptoms medication may be needed to reduce the intensity or duration of symptoms. Options include:
- Antiviral medication—may shorten the duration of the infection when taken early
- Corticosteroids—to reduce inflammation around the nerve
- Benzodiazepines—to reduce vertigo symptoms
- Pain medication
Other treatments are based on the symptoms that are present. Eye care may be needed if the infection is making it difficult to completely close your eyes.
The herpes zoster vaccine
may decrease the likelihood of getting shingles including Ramsay Hunt syndrome.
The vaccine is recommended for most people aged 60 years and older. People with a suppressed immune system should get the vaccine starting at age 50.
National Institute of Neurological Diseases and Stroke
Canadian Neurological Association
Herpes zoster oticus. National Institute of Neurological Diseases and Stroke website. Available at: http://www.ninds.nih.gov/disorders/ramsay2/ramsay2.htm. Updated February 14, 2011. Accessed March 12, 2014.
Office of rare disease has other info
Information. Ramsay Hunt website. Available at: http://www.ramsayhunt.org/info. Accessed March 12, 2014.
Shingles (herpes zoster). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/shingles/about/index.html. Updated January 10, 2011. Accessed March 12, 2014.
Sweeney CJ, Gilden DH. Ramsay Hunt syndrome. J Neurol Neurosurg Psychiatry. 2001;71(2):149-154.
Zoster. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 28, 2014. Accessed March 12, 2014.