Herpes Zoster Oticus (Ramsay Hunt Syndrome II)

Ramsay Hunt syndrome is a complication related to shingles. It occurs when the shingles infection, which is caused the same virus as chickenpox, affects the facial nerve. After you’ve had chickenpox, the virus responsible lies dormant in the body. When it is reactivated, this can result in shingles and if shingles affects the facial nerve close to one of your ears, this is defined as Ramsay Hunt syndrome.

What causes Ramsay Hunt syndrome?

Ramsay Hunt syndrome affects people who have already had chickenpox. It occurs when the virus is activated after lying dormant and is characterised by shingles affecting the facial nerve close to the ear. Shingles is a very unpleasant infection that causes a painful rash of fluid-filled blisters to develop on the skin.

Ramsay Hunt syndrome can affect anyone who has had chickenpox before, but it is most commonly found in people aged over 60 years old. This condition is not contagious, however the virus can be passed on and this may cause symptoms of chickenpox in people who have not previously been infected. If you do have chickenpox, it’s advisable to steer clear of others until the spots have scabbed over. It is particularly important to avoid pregnant women, older people, newborn babies and people with compromised immunity.

What are the symptoms?

There are two main symptoms of Ramsay Hunt syndrome: a painful rash made up of fluid-filled sores around one ear and weakness and loss of sensation around the affected nerve. You may also experience:

• hearing loss in the affected ear
• pain in your ears
• tinnitus (ringing in your ears)
• a spinning sensation similar to vertigo
• impaired sense of taste

How is Ramsay Hunt syndrome diagnosed?

A diagnosis can usually be made based on medial history and symptoms, however a sample of fluid from the rash may be used to confirm a diagnosis.

Treatment options

Early treatment is beneficial for preventing complications and easing symptoms. Treatments that may be used include:

• antiviral medication
• corticosteroids
• anti-anxiety medication (this is used to help the symptoms associated with vertigo)
• pain relief medication

Possible complications of Ramsay Hunt syndrome include permanent hearing loss and paralysis in the facial muscles, damage to the eyes, impaired sight and a painful condition known as postherpetic neuralgia. This occurs when shingles causes damage to the nerve fibres, causing the signals they send to become confused.

You can also help to ease symptoms at home by keeping your rash clean, applying cold damp compresses to your skin and using over the counter painkillers. If you have sore or itchy eyes, you may wish to use drops to keep them moist.