Ramsay Hunt Syndrome (cont.)

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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.

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

The prognosis for Ramsay Hunt syndrome is not as good as that for Bell's palsy. There is good clinical evidence to suggest that treatment with steroids, pain medications, and antiviral agents (like acyclovir, valacyclovir or famciclovir) improve recovery and lessen the extreme facial discomfort. pain. However, infrequent complications can develop, such as synkinesis (inappropriate nerve responses such as blinking or tear formation while trying to talk), eye damage, or rarely, viral spread to other nerves causing many other problems (for example, pain, confusion, weakness). Postherpetic neuralgia (pain due to nerve fiber damage by the virus) may also develop and persist for months to years.


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