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November 21, 2009
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Ramsay Hunt Syndrome

Medical Author: Charles Davis, MD, PhD
Medical Editor: Melissa Conrad Stöppler, MD

What is Ramsay Hunt syndrome? What causes it?

Ramsay Hunt syndrome (also termed Hunt's Syndrome and herpes zoster oticus) is a herpes zoster virus infection of the geniculate ganglion of the facial nerve. It is caused by reactivation of herpes zoster virus that has previously caused chickenpox in the patient. Ramsay Hunt syndrome results in paralysis of the facial muscles on the same side of the face as the infection. So, the virus infects the facial nerve that normally innervates controls the muscles of the face. Ramsay Hunt syndrome is typically associated with a red rash and blisters (inflamed vesicles or tiny water-filled sacks in the skin) in or around the ear and eardrum and sometimes on the roof of the mouth or tongue.

What are the symptoms of Ramsay Hunt syndrome?

The classic symptom that clinically distinguishes Ramsay Hunt syndrome is a red painful rash associated with blisters in the ears or mouth and facial paralysis (for example, eyelid or mouth) on one side of the face. Other symptoms such as ear pain, hearing loss, dizziness (or vertigo), dry eye, and changes in taste sensation may also occur.

How is Ramsay Hunt syndrome diagnosed?

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.

Is Ramsey Hunt syndrome contagious?

The syndrome is not contagious; however, the herpes zoster virus that can be found in the blisters of Ramsay Hunt syndrome can be transmitted to other people and cause chickenpox in those that are unvaccinated against chickenpox. Individuals with Ramsay Hunt syndrome should avoid contact with newborns, pregnant women, immunodepressed individuals, and people with no history of chickenpox, at least until all the blisters change to scabs.



Next: How does Ramsay Hunt syndrome compare with Bell's palsy? »

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Ramsay Hunt Syndrome

What is the facial nerve?

The facial nerve is a nerve which controls the muscles on the side of the face. It allows us to show expression, smile, cry, and wink. Injury to the facial nerve causes a socially and psychologically devastating physical defect; treatment may require extensive rehabilitation or multiple procedures.

The facial nerve is the seventh of the twelve cranial nerves. Everyone has two facial nerves, one for each side of the face. The facial nerve travels with the hearing nerve (the eighth cranial nerve) as it travels in and around the structures of the middle ear. It exits the front of the ear at the stylomastoid foramen (a hole in the skull base), where it then travels through the parotid gland. In the parotid gland it divides into many branches which provide motor function for the various muscles and glands of the head and neck.

What are symptoms of a facial nerve problem?

Facial nerve problems ...

Read the Facial Nerve Problems and Bell's Palsy article »



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