Ramsay-Hunt Syndrome , or Herpes Zoster Oticus, is a viral disease, also known as shingles in ear. It arises from the reactivation of the varicella zoster virus. Shingles is usually noticeable as a painful rash. The causes of the outbreak are often unknown, but the main cause is the weakening of the immune system.
Ramsay-Hunt Syndrome, occurs when the herpes zoster virus affects in the facial and cranial nerves. It is the cranial nerve that controls hearing and balance. This particular virus rests in the nerve roots after chickenpox and can be reactivated if the immune system is weakened. It migrates along the nerve tracts and causes inflammation of the affected nerve tissue up to the skin, where painful wounds then develop. These wounds are caused by burst vesicles, which then form a crust and gradually heal. This rash with small blisters behind the ear and in the ear usually indicates shingles in the ear, a herpes zoster oticus.
The symptoms of Ramsay Hunt Syndrome are different but clear. The first sign that make you recognise shingles in the ear is a burning pain under the skin. You can feel this days before the familiar blisters form. In addition, itching and hypersensitivity can occur on the affected skin area and the affected person often feels exhausted and feverish. Herpes zoster oticus can also be recognised by the following symptoms:
These painful blisters usually appear:
Occasionally on the tongue, roof of the mouth, or neck
They are a hallmark of herpes zoster oticus and may crust over after a few days.
This is a defining feature of Ramsay Hunt Syndrome. It typically affects one side of the face and may cause:
Ramsay Hunt Syndrome (herpes zoster oticus) is caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox and shingles. After a person recovers from chickenpox, the virus remains dormant in the nerve ganglia, clusters of nerve cell bodies near the spinal cord or cranial nerves. It can reactivate years later, particularly in the facial nerve near the ear, leading to Ramsay Hunt Syndrome.
A weakened immune system is the most common trigger for VZV reactivation. This can be due to:
The diagnosis of shingles in the ear is usually easy for the attending physician to make. A physical examination of the patient can determine the viral infection. The vesicles and redness on the ear and in the area of the ear are characteristic of herpes zoster oticus. Further diagnostics are only necessary in rare problem cases. If in doubt, the doctor will have the pathogen detected in the secretion of the vesicles or - if the brain is suspected of being involved - in the cerebrospinal fluid.
Antiviral drugs are used to treat shingles in the ear. These drugs stop the virus from multiplying and relieve pain and improve skin symptoms within two hours. In the case of herpes zoster oticus, anesthetic ear drops are also used to relieve the pain, and even antibiotic ear drops, as there is an additional risk of bacterial infection. Antiviral therapy should be started no later than 72 hours after the onset of the skin symptoms, so the person concerned should contact the doctor about this if he has any first suspicions.
Home remedies
Find out some tips for keeping your ears clean & healthy
Both Bell’s palsy and Ramsay Hunt Syndrome involve sudden facial paralysis, but they have different causes and symptoms. Bell’s palsy is often linked to a viral infection, commonly the herpes simplex virus, and usually appears without warning, often without pain or other symptoms. Most people recover fully within a few weeks.
Ramsay Hunt Syndrome, on the other hand, is caused by the reactivation of the varicella-zoster virus (the same virus that causes chickenpox and shingles). It typically presents with additional symptoms such as severe ear pain, a blistering rash around the ear, hearing loss, and dizziness. Recovery can take longer, and the condition is generally more complex to treat.
While many people recover well, especially with early treatment, some may experience long-term effects. These can include:
Failure to treat herpes zoster oticus can result in serious complications. This can result in hearing loss or even deafness. Peripheral fascial palsy (nerve paralysis) can also occur as a complication of herpes zoster oticus. This means that the muscles responsible for facial expressions are weak or completely paralyzed on one side. In about 80% of the cases, however, healing occurs.
Further complications can arise from the involvement of various nerves. If the vestibulochochlear nerve (inner ear) is affected, hearing loss or deafness can occur, but also ringing in ears , vertigo and nausea can occur. If other cranial nerves are affected, it can have effects such as:
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