Example of Ramsay Hunt syndrome involving the ear and facial paralysis.Ramsay Hunt syndrome, also known as herpes zoster oticus, is a virally-induced condition that can result in facial paralysis.  As its scientific name implies, the syndrome results from infection with the herpes zoster virus which causes shingles.  This is caused by the same virus that is responsible for chicken pox.  After a chicken pox infection, the virus can lay dormant in the body for years until later in life when it can resurface as shingles.  Shingles occurs most commonly in elderly individuals and those with some form of immunosuppression.  Although rare in children, anyone who has had chicken pox is at risk for developing Ramsay Hunt syndrome.

The diagnosis is usually based on history and physical exam.  A painful rash with blistering is characteristic of shingles.  In Ramsay Hunt syndrome, the rash occurs over the ear and can affect hearing.  Early treatment is required in the first week to avoid progression to hearing loss and facial paralysis.  Pain medications in combination with antiviral medications (eg, acyclovir) are initiated at the first sign of symptoms.  Steroids may also be used to reduce inflammation.  All other measures are directed at controlling the symptoms related to facial paralysis.  Eye lubrication must be used aggressively to avoid damage to the eye.  Physical therapy is also begun to encourage rapid reinnervation of the facial nerve.

Dr. Andre Panossian is an expert in the field of facial paralysis and has treated countless individuals with Ramsay Hunt syndrome.  Treatment is initiated in a multidisciplinary fashion to ensure rapid return to normal without having long-term complications.  Early intervention also ensures that recovery from facial paralysis is monitored and constantly improving.  Treatment options are available from Botox® injections to help settle spasticity in paralyzed muscles to facial reanimation procedures.