Ramsay Hunt Syndrome

Timothy C. Hain, MD.

Please read our disclaimer. Return to index Search this site


Ramsay Hunt syndrome is an acquired paralysis of the face (Bells Palsy) specifically caused by a varicella-zoster virus (VSV) infection of the facial nerve. The symptoms on the affected side typically include facial weakness, a painful herpes type skin eruption on the pinna of the ear, and there is frequently vestibulo-cochlear disturbance (i.e. there may be dizziness or a disturbance of hearing).

About 5/100,000 persons per year develop Ramsay Hunt. It is the second most common cause of acute peripheral facial paralysis.

Total recovery of facial movement occurs in about 50% of treated patients. If hearing is affected (about 1/3), complete hearing recovery occurs in about half.

Considering treatment, first one follows the usual procedures for a severe Bells palsy. Additionally, prednisone treatment and antiviral treatment, namely acylovir, are now recommended. Either 750 mg of intravenous acyclovir/day or 4000 mg of oral medication is equally effective. Hearing recovery tends to be best in patients treated within 3 days of onset with acyclovir/Prednisone. Most authors have found that only 5% of persons with Ramsay-Hunt have residual hearing loss.

References:

Murakami et al, Annals Neurology, 41, 3, 1997, 353-357

Copyright (c) 1993-2002, Timothy C. Hain, MD