Ramsay Hunt syndrome: Symptoms, Causes, Diagnosis, and Treatment

What is Ramsay Hunt Syndrome?

Ramsay Hunt syndrome is a group of symptoms due to complications of shingles or smallpox.

Other names for this syndrome are geniculate zoster, herpes zoster oticus, and herpes geniculate ganglionitis.

This condition can also occur after a person has recovered from chickenpox. This is because the cause of chickenpox and smallpox is the same virus, namely varicella-zoster.

Ramsay Hunt syndrome causes the appearance of painful skin rashes around the ears, face, or mouth.

Treatment done quickly can reduce the risk of complications that can lead to weak facial muscles and permanent loss of hearing.

Symptoms of Ramsay Hunt Syndrome

There are 2 main symptoms of Ramsay Hunt syndrome, namely:

• A painful reddish rash with fluid-filled nodules, in the ear and around.
• Paralysis or paralytic condition on the face part where there is a rash.

Usually, rashes and facial paralysis occur at the same time. However, it is possible for the rash to appear first, and vice versa.

This syndrome may also be able to cause other symptoms, such as:

• Ear pain
• Hearing deteriorating
• Buzzing ears (tinnitus)
• Difficulty closing one of the eyes
• Feeling like spinning or vertigo
• Changes in taste buds, or loss of ability to taste food
• Dry mouth and eyes

There may be signs and symptoms not mentioned above. If you have concerns about a particular symptom, consult your doctor.

Ramsay Hunt Syndrome Causes

The main cause of this syndrome is a viral infection similar to the cause of smallpox and chickenpox, namely varicella-zoster.

The virus is believed to infect a facial nerve located near the inner ear. This is what causes irritation and swelling of these nerves.

A person who has already been exposed to smallpox and recovered may still have the virus left in his nerves. However, the virus will be in the “fall asleep” phase.

A few years later, the virus can reactivate and cause the symptoms of Ramsay Hunt syndrome, especially if the body’s immune system is weakened.

How To Diagnose Ramsay Hunt Syndrome

The diagnosis of Ramsay-Hunt syndrome is generally confirmed through history and clinical examinations, complementary tests, and neuroimaging techniques.

The patient’s clinical history should include a family and personal medical history, a record of symptoms, the presentation and evolution of the pathology, in addition to other aspects.

Clinical examination should be based on a thorough examination of the existing symptoms. In addition, a neurological examination is also important to know the presence of nerve damage.

As for the commonly used supporting examinations, cytodiagnosis or serological examination of the virus, it is very important to determine the presence of infection caused by the varicella-zoster virus.

In the case of imaging tests, magnetic resonance or computed tomography, they are useful to confirm the presence of neurological damage.

In addition, other types of complementary tests are also used, such as audiometry, brainstem generation potential, or facial nerve electroneurography, to assess the degree of hearing loss and the degree of involvement of the facial nerve.

Ramsay hunt syndrome treatment

The treatment used in Ramsay-Hunt syndrome focuses on slowing down the infectious process, reducing symptoms and pain, and also reducing the risk of developing long-term neurological and physical sequelae.

Pharmacological interventions usually include:

Antiviral drugs

The purpose is to slow down the development of viral agents. Some of the drugs that specialists specialize in are Zovirax, Famvir or Valtrex.

Corticosteroids

These are usually used in high doses for a short time to enhance the effect of antiviral drugs. One of the most used is forgiveness. In addition, steroids are also often used to reduce inflammation and thus the possibility of medical sequelae.

Analgesics

It is possible that the pain associated with auditory pinna is severe, so some specialists often use drugs containing oxycodone or hydrocodone, for the treatment of analgesics.

On the other hand, other non-pharmacological therapeutic interventions, such as surgical decompression, can also be used.

This type of surgical approach is still very controversial, usually limited to cases that do not respond to drug treatment in at least more than 6 weeks.

Generally, the treatment of choice for most cases of Ramsay-Hunt syndrome is antiviral drugs and corticosteroids.