Ramsay Hunt Syndrome (RHS) is a rare neurological disorder that causes facial nerve paralysis (facial palsy) as well as an ear or mouth rash. Ear symptoms include tinnitus (ringing in the ears) and hearing loss. Ramsay Hunt syndrome is caused by the varicella-zoster virus (VZV), which also causes chickenpox in children and shingles (herpes zoster) in adults. VZV is dormant in the body and can be reactivated during periods of poor immunity or insufficient food.
Early treatment of Ramsay Hunt syndrome can reduce the risk of consequences such as permanent facial muscle paralysis and hearing loss.
THE TWO PRIMARY SIGNS AND SYMPTOMS
• A severe red rash with fluid-filled blisters on, in, and around one ear
• Facial paralysis or weakness on the same side as the afflicted ear
Typically, rash and facial paralysis occur together. Sometimes one occurs before the other. Sometimes the rash never appears.
OTHER SYMPTOMS
• Earache
• Hearing impairment
• Ringing in the ears (tinnitus)
• Having difficulty shutting one eye
• A spinning or moving feeling (vertigo)
• A change in taste perception or taste loss
• Dryness in the mouth and eyes
WHEN YOU SHOULD SEE A DOCTOR?
If you have facial paralysis or a shingles outbreak, visit a doctor right away. Early treatment beginning three days post the onset of symptoms may assist to prevent long-term problems.
CAUSES AND RISK ELEMENTS
It is most common in the elderly, pregnant women, persons with uncontrolled diabetes, and people with weakened immune systems. Patients will experience facial paralysis and sores around the ear, as well as hearing loss.
· People who have had chickenpox have high chances of developing Ramsay Hunt syndrome. The virus persists in the body post-recovery from chickenpox, occasionally reactivating years later to create shingles, a painful rash with fluid-filled blisters. It is more frequent in elderly people, usually affecting those over the age of 60. In children, it is uncommon.
· Ramsay Hunt syndrome does not spread. The varicella-zoster virus, on the other hand, can cause chickenpox in people who have never had chickenpox or been immunised against it. The sickness can be fatal in persons with weak immune systems.
TREATMENT OPTIONS
Ramsay Hunt syndrome is commonly treated with antiviral medicines such as acyclovir or famciclovir, as well as corticosteroids such as prednisone. The majority of specialists feel that starting antiviral treatment within three days after starting appears to be the most effective since early diagnosis and care are likely to improve outcomes. Facial paralysis and hearing loss may become permanent in certain cases, despite therapy.
Further treatment focuses on the symptoms that are unique to each individual. Neuralgic pain and vertigo suppressants may benefit from pain medicines, carbamazepine, and an anti-seizure prescription Because the failure to properly seal the eye may expose the cornea to abnormal dryness and foreign body irritation, persons with Ramsay Hunt syndrome should use artificial tears and lubricating ointments to avoid corneal injury. Facial physiotherapy, on the other hand, can assist keep muscles active while they recover.
Booster chicken pox vaccinations are also expected to help reduce the spread of the illness.
The writer is Consultant ENT – Head & Neck Surgery, Fortis Hospital, Bannerghatta Road, Bangalore.