The Insight to Ramsay Hunt Syndrome
By Neurosurgery Singapore
What is ramsay hunt syndrome?
Ramsay Hunt syndrome happens when shingles affects nerves in your face close to either one of your ears. Shingles affecting either ear is a condition caused by a virus called herpes zoster oticus. The general varicella-zoster virus also causes chicken pox, which is most common in children. If you’ve had chicken pox in your life, the virus can reactivate later in your life and cause shingles.
Both shingles and chicken pox are most recognizable by a rash that appears in the affected area of the body. Unlike chicken pox, a shingles rash near the facial nerves by your ears can cause other complications, including facial paralysis and ear pain. When this happens, it’s called Ramsay Hunt syndrome.
If you get a rash on your face and also start noticing symptoms such as facial muscle weakness, see our doctor as soon as you can. Early treatment can help make sure you don’t experience any complications from Ramsay Hunt syndrome.
What are some symptoms of ramsay hunt syndrome
The two main signs and symptoms of Ramsay Hunt syndrome are:
- A painful red rash with fluid-filled blisters on, in and around one ear
- Facial weakness or paralysis on the same side as the affected ear
Usually, the rash and the facial paralysis occur at the same time. Sometimes one can happen before the other. Other times, the rash never occurs.
If you have Ramsay Hunt syndrome, you might also experience:
- Ear pain
- Hearing loss
- Ringing in your ears (tinnitus)
- Difficulty closing one eye
- A sensation of spinning or moving (vertigo)
- A change in taste perception or loss of taste
- Dry mouth and eyes
“The herpes zoster virus that can be found in the blisters of Ramsay Hunt syndrome can be transmitted to other people and cause chickenpox in those who are unvaccinated against chickenpox and who have never had chickenpox. Individuals with Ramsay Hunt syndrome should avoid contact with newborns, “
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What types of diagnosis?
Diagnosis of the syndrome is most often made by observing the symptoms described above (red painful rash with ear and or mouth blisters and one-sided facial paralysis). Also, a PCR test (polymerase chain reaction) can be performed on the fluid from the blisters to demonstrate the viral genetic material, but this test is not done routinely.
Magnetic resonance imaging (MRI) may be undertaken if there are polycranial neurological symptoms.
Possible treatment methods?
If Ramsay Hunt syndrome is treated within three days of the symptoms appearing, you shouldn’t have any long-term complications. But if it goes untreated long enough, you may have some permanent weakness of the facial muscles or some loss of hearing.
In some cases, you may not be able to close your affected eye completely. As a result, your eye may get extremely dry. You may also be unable to blink out any objects or matter that gets in your eye. If you don’t use any eye drops or lubrication, it’s possible to damage the surface of the eye, called the cornea. Damage can cause constant corneal irritation or permanent (although usually minor) vision loss.
If Ramsay Hunt syndrome damages any of your facial nerves, you might also feel pain, even after you don’t have the condition anymore. This is known as postherpetic neuralgia. The pain happens because the damaged nerves don’t detect sensations correctly and send the wrong signals to your brain.
The treatment of Ramsay Hunt syndrome commonly involves antiviral medications in conjunction with corticosteroids. Most authorities agree that beginning antiviral treatment within three days of onset appears to have the greatest benefit as prompt diagnosis and management seems to improve outcomes. Despite therapy, some degree of facial paralysis and hearing loss may become permanent in some cases.
Therefore early consultation certainly helps.