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November 24, 2009
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Ramsay Hunt Syndrome (cont.)

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

Bell's palsy also is a result of injury to the facial nerve by virus infection, but the suspected cause of Bell's palsy (viral) has not been identified. Ramsey Hunt syndrome is caused by the Varicella virus (herpes zoster) that also causes chickenpox and shingles (a painful, blister-producing herpes zoster reinfection that usually occurs on one side of the body). There is no red rash associated with Bell's palsy as there is with Ramsey Hunt syndrome. Additionally, Ramsay Hunt syndrome is commonly more painful than Bell's palsy. However, both can cause eyelid and mouth paralysis on one side of the face.

Dyssynergia cerebellaris myoclona is a rare degenerative disease of the nerves characterized by epilepsy, muscle spasms, and gradually increasing tremors. Like Bell's palsy, this disease complex mimics many symptoms of Ramsay Hunt syndrome. Some investigators term the disease complex Ramsay Hunt syndrome type 2.

How is Ramsay Hunt syndrome treated or prevented?

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 (see below). 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. Fortunately, there is another vaccine, Zostavax, which is helpful in preventing viral reactivation. Consequently, shingles and Ramsay Hunt syndrome can be either prevented or their symptoms reduced if the vaccine is administered. Usually, this vaccine is given to individuals that have had chickenpox as children and are now age 60 or older. The CDC (U.S. Centers for Disease Control and Prevention) suggests the vaccine be routinely given to individuals aged 60 or older, as about 90% of the population has been exposed to chickenpox and about 20% of people that had chickenpox are likely to get shingles without the vaccine.



Next: What is the outlook (prognosis) for patients with Ramsay Hunt syndrome? »

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