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Ramsay Hunt Syndrome

Ramsay Hunt Syndrome is a neurological disease in which the Varicella Zoster virus leads to inflammation of the nerves involved in facial movements. When the nerves get inflamed, they cannot function, and there can be temporary facial palsy or paralysis. The disorder was first documented by neurologist James Ramsay Hunt in 1907. 


Key Points regarding the Ramsay Hunt Syndrome: 

  • The disease is a rare neurological disorder that is caused by the varicella-zoster virus of the human herpesvirus family. It is characterised by facial paralysis. It may also present as ear abnormalities, including ringing in the ears, earache, or hearing loss.
  • The disease is a late complication of the varicella-zoster virus infection.
  • Early-stage infection of the virus causes chickenpox in humans, but the virus in many cases remains dormant in the body long after the condition has passed. Physiological stress or immunocompromise can reactivate the virus. 
  • Less than 1 % of zoster cases involve the facial nerve and result in Ramsay Hunt Syndrome. 
  • Symptoms of the disorder: change in taste sensation, dry eyes, tearing, nasal obstruction, hyperacusis or noise sensitivity, and dysarthria or speaking difficulties.
  • The disorder is easy to miss in the early stages, and diagnosis can often be delayed, leading to long-term complications.
  • Ramsay Hunt syndrome accounts for approximately 7 % of acute facial paralysis cases. Immunocompromised patients have a higher chance of suffering from a more acute period of being infected and less complete recovery. 
  • There is no age bracket within which the virus affects humans – cases have been reported in babies as young as three months and adults as old as 82 years.
  • The treatment is mostly focused on reducing pain, preventing later complications and decreasing the duration of the illness.

What is the difference between Ramsay Hunt Syndrome and Bell’s palsy? 

  • Bell’s palsy is a condition of facial muscle weakness or paralysis that can be set off suddenly. It is not a permanent condition, although in some rare cases, it can last for longer periods. 
  • Patients of Bell’s palsy usually show full recovery. In comparison, patients of Ramsay Hunt syndrome may have more severe paralysis at the onset of the disorder and may not recover completely. 
  • Only 70 per cent of patients with Ramsay Hunt syndrome regain normal or near-normal facial function compared to over 90 per cent with Bell’s palsy.

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