Facial Paralysis & Reanimation Surgery

Ramsay Hunt Syndrome

Also known as herpes zoster oticus, Ramsay Hunt Syndrome is a rare complication of shingles – a viral disease that can occur in anyone who has had chickenpox. The virus that causes chickenpox (herpes zoster) remains dormant in the nerves and can be reactivated later in life. When the virus “wakes up” it can develop into shingles, a painful rash characterized by fluid filled blisters.

The shingles rash often appears on the torso, but it can also occur on the face and affect the facial nerve near one of the ears. When this happens, it is called Ramsay Hunt Syndrome. The rash can damage the nerve and cause facial paralysis on one side of the face and hearing loss in the affected ear.

Ramsay Hunt Syndrome is most common in people over 60 and is very rare in children.


Your health is important. Don’t delay care.

If you experience symptoms of facial paralysis or hearing loss, you should immediately seek medical help. To schedule an in-person consultation with a UH facial paralysis expert, call 216-844-3223.
Virtual appointments are also available.

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Symptoms of Ramsay Hunt Syndrome

The most common symptoms of Ramsay Hunt Syndrome are a painful rash in and around one ear and loss of facial movement on the same side as the affected ear. One or both of these symptoms may occur. Additional symptoms may include:


Diagnosis & Treatment

Anyone experiencing symptoms of Ramsay Hunt Syndrome should be medically evaluated right away. A prompt diagnosis – ideally within three days of the appearance of symptoms – ensures the appropriate treatment can begin, minimizing the risk of long-term complications.

Your doctor will take a full medical history, conduct a physical exam and look for the distinctive signs and symptoms of Ramsay Hunt Syndrome. A sample of the fluid from the rash blisters might be taken for testing to confirm the diagnosis.

If the diagnosis is confirmed, your doctor may prescribe the following treatments:

  • Antiviral medications
  • Corticosteroids (may boost the effect of the antiviral drugs)
  • Anti-anxiety medications if vertigo is a symptom
  • Pain medications
  • Moisturizing eye drops if eyelid closure is a problem

Potential Complications of Ramsay Hunt Syndrome

Prompt and aggressive treatment is essential for people with Ramsay Hunt Syndrome. If untreated or treatment is delayed, serious complications can occur, including:

  • Permanent facial muscle weakness/paralysis
  • Total hearing loss in the affected ear
  • Damage to the eye if eyelid closure is affected
  • Nerve pain that persists after other symptoms have faded

Can Ramsay Hunt Syndrome Be Prevented?

The best protection against shingles and Ramsay Hunt Syndrome is to be vaccinated against chickenpox, reducing the chances of becoming infected with the virus. Most children now receive the chickenpox vaccine as part of their childhood vaccine regimen. However, even if vaccinated for chickenpox as a child, adults over 50 should receive the shingles vaccine as immunity wanes over time.

Your health is important. Don’t delay care.

If your facial paralysis symptoms persist and do not improve with conservative treatments, call 216-844-3223 to schedule an in-person consultation with a UH ENT facial plastic surgeon.

Virtual appointments are also available.