Ramsay Hunt syndrome

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Symptoms

By Mayo Clinic staff

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Illustration showing facial weakness 
Facial paralysis

The two main signs of Ramsay Hunt syndrome are:

  • A painful red rash with fluid-filled blisters on, in and around one ear
  • Facial weakness or paralysis on the same side as the affected ear

Usually, the rash and the facial paralysis develop at the same time. But in some cases, the rash will occur before the facial paralysis, or the paralysis before the rash. Sometimes, the rash never materializes.

If you have Ramsay Hunt syndrome, you might also experience:

  • Ear pain
  • Hearing loss
  • Ringing in your ears (tinnitus)
  • Difficulty closing one eye
  • A sensation of spinning or moving (vertigo)
  • A change in taste perception or loss of taste

When to see a doctor
Call your doctor if you experience facial paralysis or a shingles rash on your face. Treatment beginning within seven days of the start of signs and symptoms may help prevent long-term complications.

References
  1. Herpes zoster oticus information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/ramsay2/ramsay2.htm. Accessed Oct. 26, 2010.
  2. Davis LE. Varicella zoster virus deafness and vertigo. In: Flint PW, et al. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-05283-2..00153-1--s0090&isbn=978-0-323-05283-2&sid=1074288621&type=bookPage&sectionEid=4-u1.0-B978-0-323-05283-2..00153-1--s0180&uniqId=224115609-5#4-u1.0-B978-0-323-05283-2..00153-1--s0180. Accessed Oct. 26, 2010.
  3. Neilan RE, et al. Otalgia. Medical Clinics of North America. 2010;94:961.
  4. Fort GG. Ramsay Hunt syndrome. In: Ferri FF. Ferri's Clinical Advisor 2011. Philadelphia, Pa.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/page.do?sid=1074741540&eid=4-u1.0-B978-0-323-05610-6..00027-5--sc0020&isbn=978-0-323-05610-6&type=bookPage&sectionEid=4-u1.0-B978-0-323-05610-6..00027-5--sc0020&uniqId=224270956-3. Accessed Oct. 27, 2010.
  5. Harpaz R, et al. Prevention of herpes zoster: Recommendations of the advisory committee on immunization practices (ACIP). Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report. 2008;57:RR-5.
  6. Guss J, et al. Infections of the external ear: Herpes zoster oticus. In: Flint PW, et al. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-05283-2..00138-5--s0110&isbn=978-0-323-05283-2&sid=1074768459&type=bookPage&sectionEid=4-u1.0-B978-0-323-05283-2..00138-5--s0110&uniqId=224270956-6#4-u1.0-B978-0-323-05283-2..00138-5--s0110. Accessed Oct. 27, 2010.
DS00878 Jan. 8, 2011

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