Ramsay Hunt Syndrome
Ramsay Hunt syndrome or herpes zoster oticus, is a rare neurological disorder that occurs when the varicella-zoster virus (shingles) reactivates and spreads to the facial nerves near your inner ear. It typically affects adults over 60 years of age. It is a complication of varicella-zoster virus infections, including chickenpox or shingles (herpes zoster).The disorder is the second most common cause of facial nerve paralysis, accounting for about 7% of all cases.
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.
Other symptoms, you might also experience are –
• 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
Causes & Risk Factors –
Ramsay Hunt syndrome occurs when the varicella-zoster virus reactivates in the facial nerve, which is the cranial nerve that affects your face, tongue and inner ear. The varicella-zoster virus is the same virus that causes chickenpox and shingles.
If you had chickenpox as a child, the virus can remain inactive (dormant) in your nerves for years. Shingles occurs when the previously dormant varicella-zoster virus reactivates. The virus travels down your nerve fibers into your skin, causing painful sores. The virus sometimes develops into Ramsay Hunt syndrome, affecting your facial nerve.
Because Ramsay Hunt syndrome is caused by shingles, it has the same causes and risk factors. These include:
• previously having chicken pox
• being older than 60 years (it rarely occurs in children)
• having a weak or compromised immune system
• Permanent hearing loss and facial weakness.
For most people, the hearing loss and facial paralysis associated with Ramsay Hunt syndrome is temporary. However, it can become permanent.
• Eye damage.
The facial weakness caused by it may make it difficult for you to close your eyelid. When this happens, the cornea, which protects your eye, can become damaged. This damage can cause eye pain and blurred vision.
• Postherpetic neuralgia.
This painful condition occurs when a shingles infection damages nerve fibers. The messages sent by these nerve fibers become confused and exaggerated, causing pain that may last long after other signs and symptoms of Ramsay Hunt syndrome have faded
A health care provider will usually diagnose Ramsay Hunt Syndrome by looking for signs of weakness in the face and a blister-like rash.
Tests may include:
• Blood tests for varicella-zoster virus
• Electromyography (EMG)
• MRI of the head
• Nerve conduction (to determine the amount of damage to the facial nerve)
• Skin scrapings to test for varicella-zoster virus
Ramsay Hunt syndrome treatment may include various medications according to symptoms which includes-
• An antiviral medication to treat the infection or decrease symptoms, such as acyclovir or valacyclovir.
• A corticosteroid to reduce inflammation of the nerve, such as prednisone.
• A pain reliever to reduce pain.
• A variety of possible medications to relieve symptoms of vertigo.
• An anti-seizure medicine, such as carbamazepine, to treat persistent pain (postherpetic neuralgia).
• Natural treatment for Ramsay Hunt syndrome includes using a cold compress to reduce your pain.
• You may also consider wearing an eye patch. If you’re unable to close your eye, you risk damaging your cornea due to irritation. You may also want to use artificial tears or eye lubricants to prevent your eye from drying out.
Children should be vaccinated against chickenpox, which greatly reduces the chances of becoming infected with the chickenpox virus. A shingles vaccine for people age 50 or older also is recommended.
Overall, your chances of recovery are better if the treatment is started within 3 days after the symptoms begin. When treatment is started within this time, most people make a full recovery. If treatment is delayed for more than 3 days, there is less of a chance of complete recovery. Children are more likely to have a complete recovery than adults.
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