Ramsay Hunt syndrome

Ramsay Hunt syndrome is often identified by a painful rash with fluid-filled blisters on, in or around one ear. Other symptoms may include ear pain, hearing changes, a feeling of spinning or moving called vertigo. There may be loss of movement, called paralysis, of the face on the same side as the rash.

To confirm the diagnosis, your healthcare professional may test a sample of fluid from one of the rash blisters.

Ramsay Hunt syndrome isn't contagious. But the virus that causes it can spread to people who haven't had or been vaccinated for chickenpox. Until the rash blisters scab over, stay physically apart from:

• Pregnant people and newborn babies.
• People who never had chickenpox and who never had the chickenpox vaccine.
• People with weakened immune systems.

If possible, cover the rash blisters until they scab over.

Get treatment for Ramsay Hunt syndrome right away to lower the risk of long-term complications. People who start treatment within three days of symptoms have a higher chance of recovering from facial paralysis. Medicines may include antivirals, corticosteroids and pain relievers.

• Antiviral medicine. This type of medicine (valacyclovir, acyclovir, famciclovir) focuses on stopping the virus from spreading. Antiviral medicine is usually given as pills but may be given by IV if necessary.
• Corticosteroids. Prednisone is often recommended for about five days.
• Pain relievers. Pain medicine you can get without a prescription may be suggested. But pain from the rash can be serious. A prescription for pain medicine may be needed.

Ramsay Hunt syndrome can be very painful. To manage it, make sure to take pain relievers as directed. If the rash is itchy, use a cool, wet cloth to press on the area. Don't scratch your ear or face.

If you have trouble closing one eye because of the facial paralysis, take steps to protect your vision.

• Use moisturizing eyedrops throughout the day if your eye becomes dry.
• At night, apply ointment to the eye, and tape your eyelid shut or wear an eye patch.

You may start by seeing a member of your regular healthcare team. Then, depending on your symptoms, you may see a doctor who specializes in the nervous system, called a neurologist. Or you may see a healthcare professional focusing on the ear, nose and throat, called an otolaryngologist.

What you can do

Before your appointment, you may want to write down:

• Your symptoms, including any that seem unrelated to the reason for your appointment.
• Key personal information, including major stresses, recent life changes and family medical history.
• All medicines, vitamins or supplements you take, including the doses.
• Questions to ask your healthcare professional.

For shingles, some basic questions to ask your healthcare professional include:

• What's likely causing my symptoms?
• Other than the most likely cause, what are other possible causes for my symptoms?
• What tests do I need?
• Is my condition likely temporary or chronic?
• What's the best course of action?
• What are the alternatives to the primary approach you're suggesting?
• I have these other health conditions. How can I best manage them together?
• Are there restrictions I need to follow?
• Should I see a specialist?
• Are there brochures or other printed material that I can have? What websites do you recommend?

Take a family member or friend along, if possible, to help you remember the information you're given.

What to expect from your doctor

Your healthcare professional is likely to ask you several questions, such as:

• Have you ever had chickenpox? Have you had the chickenpox vaccine?
• Have you had a sensation that the room is spinning, called vertigo?
• Has your hearing been affected?
• Have you noticed a change in your sense of taste?
• What, if anything, seems to improve or worsen your symptoms?
• Are you being treated for any chronic health conditions? If so, what treatments are you receiving?
• Are you pregnant?

During the physical exam, your healthcare professional will closely examine your face to check for evidence of one-sided facial paralysis or a shingles rash on, in or around your ear.