Ramsey Hunt Syndrome: Why is it a complex condition and who does it affect?

Ramsey Hunt Syndrome can cause severe facial paralysis, hearing loss, and pain — this article provides an overview on the complexities of the condition and who is affected by it.

Jun 10, 2022 - 15:08
Mar 9, 2023 - 14:45
Ramsey Hunt Syndrome: Why is it a complex condition and who does it affect?
Ramsay Hunt Syndrome - FantasyArticles

Justin Bieber, a famous and beloved singer, recently shared a distressing update on Instagram. He explained in a video message that he is suffering from a severe illness that has caused paralysis on the right side of his face, affecting his ability to speak, blink, and breathe. He revealed that he has been diagnosed with a rare and complex condition called "Ramsay Hunt Syndrome." Now you might have some questions about, What exactly is this condition? Are there any available treatments? And who is susceptible to this complex disease?

Justin Bieber Ramsay Hunt Syndrome

Well, Ramsay Hunt Syndrome (RHS) is a rare neurological disorder caused by a type of virus. This complex disease results in facial nerve paralysis (facial palsy) and affects the ear or mouth.

Cause of Infection:

Ramsay Hunt Syndrome is caused by the varicella zoster virus (VZV). This same virus causes chickenpox in children and shingles (herpes zoster) in adults. In the case of Ramsay Hunt Syndrome, if the dormant/inactive VZV virus is present in the body previously, it becomes active again and spreads to affect the facial nerve, resulting in the paralysis of the affected area.

History of Ramsay Hunt syndrome:

In the past, this condition has been given various names in medical literature, which has created confusion. Later, James Ramsay Hunt, a physician who fully described this condition in 1907, gave it its name. Because of the distinctive feature of ear canal vesicles, this condition is also known as "herpes zoster oticus" at times. Some doctors use the term "herpes zoster oticus" only for ear canal vesicles, and use the term "Ramsay Hunt syndrome" for a combination of ear canal vesicles and facial paralysis.

Symptoms and Effects:

Individuals affected by Ramsay Hunt Syndrome may experience different symptoms, particularly in regards to paralysis of facial nerves (palsy) and ear involvement, resulting in a sensation of vertigo. These two symptoms do not always occur together. In most cases, only one side of the face is affected by the nerve palsy.

As a result of nerve paralysis, the muscles of the affected person's face may become weak or they may feel a sense of strength, and this can cause them to have difficulty laughing, blinking, or closing their eyes in the direction of the affected area. In some cases, individuals may see distorted images in front of them.

In most cases of Ramsay Hunt syndrome, there is redness (erythematous), painful, vesicular (bullous) rash that occurs outside the ear (pinna) and often affects the external part of the ear. In some cases, the painful vesicles can also affect the face, soft palate, and upper part of the throat. Ramsay Hunt syndrome can cause facial paralysis without any abnormality of the skin in some affected individuals.

There are additional symptoms that can affect the ear, such as ringing in the ears (tinnitus) and ear pain (otalgia). In some cases, the ear pain can become extremely severe. This pain may gradually spread to other parts of the head to cause a headache.

Some affected individuals experience a decrease in their sensitive hearing ability, where there is a situation where sound is not accurately transmitted to the brain due to damage to the inner ear or auditory nerve. This can cause a reduction in hearing ability. This reduction in hearing ability is generally temporary, but in rare cases it can be permanent. Other possible symptoms that may be present include nausea, vomiting, loss of taste, dry mouth, and dry eyes.


In the treatment of Ramsay Hunt syndrome, antiviral medications such as acyclovir or famciclovir are usually prescribed. Most experts agree that starting antiviral therapy within three days of the onset of symptoms is most beneficial because it immediately identifies the disease and leads to good management outcomes.

However, even with therapy, facial paralysis and hearing loss can be permanent in some cases. In addition to various pain medications, carbamazepine, an anti-itch medication that can help reduce nerve pain, and antihistamines and anticholinergics like vertigo suppressive medications may be given. Special care must be taken to prevent corneal abrasions in individuals with Ramsay Hunt syndrome, as closing the eye properly may be impaired due to paralysis, and artificial tears and lubricants may be used to protect the cornea.

If we were to talk about being completely cured of this disease, it can be said that if the nerve damage of the sufferer is not too severe, then they will have to recover completely within a few weeks. If the damage is more serious, however, they may not fully recover even after several months. In general, the likelihood of a complete recovery greatly increases if treatment is started within 3 days of the onset of symptoms.

What's Your Reaction?