Ramsay Hunt Syndrome
Original Editor - Wendy Walker
Lead Editors - Wendy Walker, Poonam Sepat, Kim Jackson, Evan Thomas, WikiSysop, Claire Knott, Naomi O'Reilly and Wendy Snyders
Introduction[edit | edit source]
Ramsey Hunt Syndrome [RHS] is a peripheral facial nerve palsy caused by an infection with the virus Varicella Zoster virus.
It is generally accompanied by a rash (which can be painful) in the area of the ear and/or the mouth.
The auditory nerve may also be involved, leading to hearing and balance effects.
Mechanism of Injury / Pathological Process[edit | edit source]
RHS is caused by reactivation of the Varicella Zoster Virus (the virus which causes chicken pox) within the sensory ganglion of the Facial Nerve, the 7th Cranial Nerve. As the 8th Cranial Nerve, known as the Auditory Nerve or the Vetibulocochlear Nerve, lies next to the sensory ganglion of the facial nerve within the facial canal, both nerves are usually involved[1].
Clinical Presentation[edit | edit source]
The most common presenting feature is a moderate to severe earache (otalgia). This may occur at the same time as facial palsy, or the palsy may occur a few days after the onset of earache. In addition, a painful red rash with blisters (as in the illustration) may appear; the rash can be on the pinna of the ear, within the ear canal, or inside the mouth. In addition the patient may have general signs of a viral infection, including fever, headache and general malaise.
Diagnostic Procedures[edit | edit source]
The diagnosis of RHS is a clinical diagnosis, made when the combination of ear pain, a herpetic rash in the ear or mouth and facial palsy occurs; however, virological studies can be used to confirm the diagnosis.
Differential Diagnosis[edit | edit source]
Medical Management[edit | edit source]
Physiotherapy Interventions[edit | edit source]
Physiotherapy management of the facial paralysis or weakness is as detailed in the section on Facial Palsy.
It is also important to provide information on care of the eye in order to prevent formation of corneal ulcer: see advice page on Dry Eye.
Resources[edit | edit source]
The charity Facial Palsy UK have a page on RHS
The website RamsayHunt.org offers information and support
American organisation National Organization for Rare Disorders has a useful page on RHS
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
- ↑ C J Sweeney, D H Gilden. Ramsay Hunt Syndrome J Neurol Neurosurg Psychiatry 2001;71:149-154
