Ramsay hunt syndrome (varicella infection)

Ear Nose | Otorhinolaryngology | Ramsay hunt syndrome (varicella infection) (Disease)


As a general rule, shingles is a disease of sensory nerves but Ramsay Hunts syndrome is distinctive in that there is a motor component. J. Ramsay Hunt described the various clinical presentations of facial paralysis with a rash and also recognised other frequent symptoms and signs such as tinnitus, hearing loss, nausea, vomiting, vertigo and nystagmus.

Causes and Risk factors

The Ramsay Hunts syndrome here described occurs when the varicella zoster virus (chickenpox) becomes reactivated in the geniculate ganglion of the 7th cranial nerve (facial nerve).

Diagnosis and Treatment

Diagnosis of the syndrome is most often made by observing the symptoms described above (red painful rash with ear and or mouth blisters and one-sided facial paralysis). Also, a PCR test (polymerase chain reaction) can be performed on the fluid from the blisters to demonstrate the viral genetic material, but this test is not done routinely.

Treatment consists of antiviral agents (for example, acyclovir, valacyclovir or famciclovir) for about one week, steroids (prednisone), and pain medications. Best results are reported when treatment protocols are started within about three days after symptoms appear. Early treatment usually results in a better prognosis.

For children, the varicella vaccine can reduce the chance of getting chickenpox from which the syndrome comes (reactivation of the virus). However, once a person gets chickenpox, the person is susceptible to reactivation of the virus and thus can develop shingles and/or Ramsay Hunt syndrome. ...

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