Ramsay Hunt Syndrome

Original Editor - Wendy Walker

Lead Editors  - Wendy Walker

Introduction

Ramsay Hunt syndrome is defined as an acute peripheral facial neuropathy associated with erythematous vesicular rash of the skin of the ear canal, auricle (also termed herpes zoster oticus), and/or mucous membrane of the oropharynx.

Mechanism of Injury / Pathological Process

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Clinical Presentation

The presenting feature is often pain deep within the ear. 

A herpetic rash or blisters, which may be on the skin of the ear canal, auricle or both.

Diagnostic Procedures

In most cases, the diagnosis is made purely on clinical findings: the presence of herpetic blisters in and around the ear, accompanied in most cases by pain in and around the ear and an ipsilateral facial palsy.

On occasions virological studies, both serological and molecular, can be used to confirm the clinical diagnosis.

In particular, VZV antigen detection by direct immunofluorescence assay (DFA) is used, which has sensitivity of 90% and specificity close to 99%.

Structural lesions (such as Acoustic Neuroma) can be ruled out by MRI or CT scan.

Outcome Measures

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Management / Interventions

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Differential Diagnosis

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Key Evidence

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Resources

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Case Studies

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References

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