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What causes Ramsay Hunt Syndrome?

Ramsay Hunt Syndrome, also known as herpes zoster oticus, is a condition that arises when a shingles outbreak affects the functioning of the facial nerve near an ear. Beyond the discomfort of the shingles rash, Ramsay Hunt Syndrome can lead to facial paralysis and hearing loss in the ear affected by the outbreak.

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The onset of facial weakness

In Ramsay Hunt Syndrome, individuals may experience abrupt onset facial weakness over the course of hours to a few days. This weakness can be particularly distressing, as it affects one’s ability to control facial muscles and convey emotions through facial expressions. It is imperative that you seek immediate medical attention to diagnose and treat this concerning symptom.

Diagnosing Ramsay Hunt Syndrome

Diagnosing Ramsay Hunt syndrome can be challenging because its symptoms, including earache, facial paralysis, and a distinct rash, may not appear all at once. Diagnosis relies on a comprehensive clinical assessment, a detailed patient history, and identifying characteristic signs such as one-sided facial palsy and a rash around the ear. 

Confirmatory diagnosis can be achieved by analyzing a sample from the fluid-filled blistering rash near the ear. This rash serves as a valuable indicator that distinguishes Ramsay Hunt syndrome from other conditions such as Bell’s palsy, acoustic neuroma, or trigeminal neuralgia. While viral studies can detect the varicella-zoster virus in saliva, tears, and blood, they are typically unnecessary for establishing a Ramsay Hunt syndrome diagnosis.

What are the treatments for Ramsay Hunt Syndrome?

To address recovery and improve overall facial appearance and function in Ramsay Hunt Syndrome, several treatment options may be considered:

Physical therapy

Physical therapy plays a crucial role in helping individuals with Ramsay Hunt Syndrome regain control over their facial muscles. Therapists use targeted exercises and techniques to enhance facial symmetry and movement.


Anti-inflammatory medications (steroids) work to address inflamed nerves and reduce pain. When the medication is started within three days of the onset of symptoms, the recovery rate is quite high. Antiviral medications may also be prescribed. 

Other treatments

In some cases, additional treatments may be recommended to address specific issues related to Ramsay Hunt Syndrome. The choice of intervention depends on the individual’s symptoms and condition.

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What is the recovery after Ramsay Hunt Syndrome?

Recovery from Ramsay Hunt Syndrome can be complex and sometimes disorganized. While some individuals may naturally regain facial function over time, others may experience a long-lasting impact on facial motions, requiring specialized treatments. “Over-recovery” is characterized by excessive and uncontrolled facial muscle movements during attempted facial expressions.

Expert care for Ramsay Hunt Syndrome

At the Hadlock Center for Facial Plastic Surgery, we offer specialized care for individuals facing Ramsay Hunt Syndrome symptoms. Dr. Tessa Hadlock, our renowned clinician-scientist and founder, has extensive experience in facial plastic and reconstructive surgery, making her a leading expert in the field. Our commitment to personalized care ensures that each patient receives a tailored treatment plan designed to address the unique challenges of Ramsay Hunt Syndrome. We collaborate with a team of experts to provide comprehensive care, from non-invasive therapies to specialized surgical procedures.

When you choose the Hadlock Center, you’re selecting a team dedicated to improving the lives of individuals with Ramsay Hunt Syndrome. We understand the physical and emotional challenges associated with this condition and are here to provide hope, expertise, and compassionate care on your journey to recovery. Ramsay Hunt Syndrome may present complex recovery challenges, but with the right treatment and intervention, individuals can regain control over their facial expressions and improve their quality of life. Choose the Hadlock Center for Facial Plastic Surgery for compassionate and effective care.

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