Ramsay Hunt syndrome (RHS), also known as herpes zoster oticus, is a rare condition that causes facial weakness or paralysis, and a rash on the outer ear, sometimes including the ear canal and ear drum.
New infections with or reactivation of a childhood virus can spread and affect the facial nerve, which controls movement of each side of the face. This virus is known as varicella zoster virus (VZV) and is known for causing chickenpox and shingles. The virus also causes the ear to break out in a painful rash.
Symptoms of RHS all occur on the same side of the face but may not occur at the same time. They include:
RHS is caused by a reactivation of the herpes zoster virus that may have caused chickenpox in childhood. This virus stays in the body and can attack the nerve that controls facial movements (facial nerve) and the sensory nerve that supplies the face (trigeminal nerve). This virus can also cause shingles, a stinging rash on one side of the body, in adults. RHS occurs in one out of every 20,000 people each year, usually in older adults but rarely in children. It can affect men and women equally.
Treatment for RHS includes antiviral therapies and corticosteroids. Starting these medications as soon as possible helps improve recovery. When symptoms are severe, these medications can be given intravenously (IV) in the hospital.
RHS can be a very painful condition, too. Pain control with multiple types of medications is important during treatment and even after the rash goes away and facial movement returns. Because patients have difficulty closing the eye due to facial nerve paralysis, eye moisturization and lubrication is very important. Medications for nausea and dizziness are also helpful during treatment to support recovery.