Overview
Ramsay Hunt syndrome, also called herpes zoster oticus, is caused when the varicella-zoster virus affects certain nerves of the face. It causes a painful rash called shingles. The rash may be mostly around the ear or may affect the ear, face and mouth. This syndrome may cause changes to hearing, taste and balance. It also may cause loss of movement on the side of the face where the shingles rash occurs.
The risk of Ramsay Hunt syndrome goes up as you age or if your immune system is weakened.
Get treatment for Ramsay Hunt syndrome right away to lower the chance of any permanent health issues. A vaccine to prevent shingles can help lower the risk of Ramsay Hunt syndrome.
Facial nerve
The nerve that controls your facial muscles passes through a narrow corridor of bone on its way to your face.
Symptoms
The most common symptom of Ramsay Hunt syndrome is a painful rash with fluid-filled blisters on, in or around one ear. The rash may be a shade of red, purple, or brown depending on your skin color.
Other symptoms of Ramsay Hunt syndrome may be:
- Loss of movement, called paralysis, of the face on the same side as the rash.
- Ear pain.
- Ringing sound in the ear that doesn't stop, called tinnitus.
- Hearing loss or hearing that is very sensitive.
- Fast, random eye movements.
- A feeling of spinning or moving, called vertigo.
With Ramsay Hunt syndrome, you may tear up in one eye. Some people taste things differently on one side of the tongue, or there may be sores on the tongue.
Facial paralysis
Weakness or loss of movement, called paralysis, in the nerves of the face may cause one corner of the mouth to droop. Weakness or paralysis also may make it difficult to close the eye on that side of the face.
When to see a doctor
Contact a healthcare professional if you have weakness or loss of movement in your face or if you have a painful rash on your face. Starting medicine to treat Ramsay Hunt syndrome withing three days of symptoms may help prevent long-term complications.
Causes
Ramsay Hunt syndrome is caused by the varicella-zoster virus. When the virus first infects a person, the disease it causes is called chickenpox. The immune system clears most of the varicella-zoster virus out of the body. But the virus can hide in nerves, waiting until the immune system is less active. Then the virus awakens and causes a rash called shingles. If the virus wakes up in certain facial nerves, that's called Ramsay Hunt syndrome.
Risk factors
Anyone who has had chickenpox can get Ramsay Hunt syndrome. The main risk factor for Ramsay Hunt syndrome is a weakened immune response. The syndrome is caused by the varicella-zoster virus in the facial nerves escaping immune system control.
The immune system may be weakened due to age, medical treatment, medicine or HIV infection.
Risk factors for getting shingles include being female and, among people age 65 and older, being physically injured. Some chronic illnesses, such as lung or kidney disease, may raise the risk of shingles as well.
Complications
Ramsay Hunt syndrome can cause lasting symptoms called complications. Long-term symptoms of Ramsay Hunt syndrome may include:
- Weakness or lack of movement in the face that doesn't go away. Getting treatment quickly can help lower the risk of permanent facial paralysis or weakness.
- Hearing changes. This includes loss of hearing or hearing that is very sensitive.
- Ear pain. The damage to nerve fibers can cause pain that lasts after the rash has been treated.
Prevention
The shingles vaccine lowers the risk of getting shingles and related conditions such as Ramsay Hunt syndrome. This vaccine is often recommended for people over age 50 or adults of any age who have weakened immune systems.
Also, getting the vaccine against chickenpox as a child may lower the risk of serious illness from shingles later in life. The first children to get chickenpox vaccines aren't old enough to be at high risk of shingles, but shingles infection does happen. Research comparing shingles in younger people finds that those who got the chickenpox vaccine had a lower rate of shingles compared with those who had chickenpox virus infection.
