All About Ramsay Hunt Syndrome

Ramsay Hunt syndrome is one of the leading causes of paralysis of the facial nerve (facial palsy). It can also cause other symptoms, such as hearing loss or dizziness. In this article, we’ll tell you all about it.
All About Ramsay Hunt Syndrome

Last update: 17 May, 2021

Ramsay Hunt syndrome is caused by the same virus that causes chickenpox. It causes symptoms and signs that appear because this virus is capable of affecting certain nerves, specifically the facial nerve.

The facial nerve is made up of motor and sensory fibers. It innervates different parts of the face. Thus, it allows you to make different gestures, such as those to eat and speak. Ramsay Hunt syndrome can cause facial paralysis and hearing loss in the same side of the affected ear.

In this article, we’ll tell you everything you need to know about it.

What’s Ramsay Hunt syndrome?

Ramsay Hunt syndrome is one of the conditions that the varicella-zoster virus (VZV) can cause. This virus belongs to the herpesvirus family.

According to an article published in the Annals of Internal Medicine, Ramsay Hunt syndrome causes paralysis of the facial nerve. In addition, it usually causes painful shingles rashes in the pinna or even inside the mouth.

It’s the second most common cause of peripheral facial nerve palsy. In fact, it accounts for 7% of all cases. This is because the varicella-zoster virus is very common in the general population.

Another study published in the journal SEMERGEN Family Medicine states that it can manifest in many different ways. That’s why medical professionals usually classify it into four stages, based on its severity. The full form, or rather the first one that experts described, causes the following:

  • Malaise, fatigue, and pain.
  • Skin rash and hearing impairment.
  • Changes in taste perception or loss of taste.
  • Peripheral facial paralysis.

Causes of Ramsay Hunt syndrome

The varicella-zoster virus causes Ramsay Hunt syndrome. It manifests in people who’ve already had chickenpox. This is because this virus can lie dormant or latent in the body. Specifically, it tends to lodge in nerve tissues.

When the virus reactivates, it causes symptoms. As an article in New York State’s Department of Health states, it’s usually transmitted from person to person by directly touching the blisters, saliva, or mucus of an infected person.

However, it can also be transmitted through the air by droplets that are expelled by coughing and sneezing. In fact, people can also get it from contaminated items. For a person to develop Ramsay Hunt syndrome, they had to have been infected with this virus.

A baby with chickenpox.
Chickenpox is the necessary precondition for this syndrome to appear later, sometimes even years later.

Risk factors

Anyone who’s had chickenpox can suffer from Ramsay Hunt syndrome. This is an essential condition. It’s important to understand that this syndrome isn’t contagious.

As with shingles, when it appears, what can spread is the virus itself. If a person who hasn’t had chickenpox comes into contact with a person who has Ramsay Hunt syndrome, what they’ll develop is the typical clinical picture of the exanthematous viral disease.

We should note that there are vaccines for this virus. Therefore, a vaccinated person can’t catch it.

Age is another key factor. Children rarely develop Ramsay Hunt syndrome. It usually appears in people over 60 years of age. Also, it’s more common in those who have weakened immune systems.

The symptoms it causes

As we explained in the first section, Ramsay Hunt syndrome can manifest in different ways. As Mayo Clinic specialists explain, the two main symptoms of this condition are facial paralysis and rash. It usually appears around or inside the ear. Also, it causes fluid-filled blisters.

In some cases, the rash doesn’t appear or it does after the paralysis. It also causes earache, constant ringing, or even hearing loss.

Facial paralysis makes the patient have a hard time closing the eye on the affected side. The mouth and eyes may dry up. This is because the facial nerve also innervates glands that are responsible for secreting tears and saliva.

Taste can also be altered. The patient loses the ability to taste food with the front part of the tongue.

The complications of Ramsay Hunt syndrome

Ramsay Hunt syndrome can cause long-term complications. One of the most severe is postherpetic neuralgia. It’s chronic pain in the area where the rash occurred.

It appears because the virus damages the nerve fibers. Similarly, facial sensitivity and hearing can be permanently impaired. However, this is somewhat less common.

Finally, it’s possible that, due to the inability to close the eye, it may become injured. Particles or agents enter the eye and damage the cornea, affecting vision.

Diagnosis of Ramsay Hunt syndrome

A doctor diagnoses the condition after assessing the patient’s symptoms and medical history. As it’s the second most common cause of peripheral paralysis, medical professionals should always consider it.

In addition, as a study published in the Clinical Journal of Family Medicine explains, a series of tests can help diagnose the condition. The first is serology. It detects if your blood has antibodies to the varicella-zoster virus.

Another test that can prove helpful is the polymerase chain reaction (PCR). In some cases, if the diagnosis is uncertain, a medical professional could request imaging to rule out other conditions. The most used is magnetic resonance imaging.

An MRI scan.
Imaging is only necessary if the doctor has to rule out other suspicious conditions, such as a brain tumor.

Available treatments

The treatment of Ramsay Hunt syndrome seeks to reduce the risk of possible complications and discomfort. For this reason, the most commonly used drugs are painkillers. They relieve the patient’s pain. In addition, the doctor may prescribe anti-anxiety drugs if the patient is suffering from vertigo.

Antivirals also prevent the virus from further multiplying. The most useful against the varicella-zoster virus are acyclovir and valacyclovir. The patient can take them with corticosteroids to boost the effect.

This article may interest you: Herpes Simplex Viruses and Their Characteristics

Ramsay Hunt syndrome only occurs in those infected by the varicella-zoster virus (VZV)

What you must remember is that this syndrome only affects people who’ve been infected by the varicella-zoster virus (VZV). It usually appears years after the infection, especially in the elderly.

It’s characterized by facial nerve palsy and a vesicular eruption.

Consult your doctor if you have any of these symptoms. Proper treatment can reduce the risk of long-term complications, such as chronic pain.

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