This picture depicts symptoms of Ramsay Hunt syndrome: facial paralysis and rashes due to damage to the facial nerve. Representational image: Wikimedia Commons
MedBound Blog

Ramsay Hunt Syndrome: A Syndrome That Affected Pop Star Justin Bieber

Dr. Siddiqua Parveen, PharmD

Ramsay Hunt syndrome is the result of late complications of varicella-zoster virus infection that usually causes chickenpox or shingles. This disease is also known as Herpes zoster oticus and Ramsay Hunt Syndrome Type 2. Ramsay Hunt Syndrome was named after American army officer and neurologist James Ramsay Hunt (1872–1937) after he first described this syndrome.

This infection causes damage to cranial nerve VII, which in turn might cause facial paralysis and hearing loss in the affected ear. The virus that causes chickenpox in children might get reactivated in later stages of life, affects the nerve, and causes Ramsay Hunt syndrome.

According to an article published in PubMed, Ramsay Hunt syndrome affects 5 per 100,000 people per year, and immunocompromised patients are the most affected.

In a video clip shared on Instagram, Dr. Agni Kumar Bose, a dermatologist and dermatosurgeon, gave a brief insight into Ramsay-Hunt syndrome. He mentioned that the conditions under which the virus gets reactivated are stress, surgery, infection, decreased immunity, and cancer chemotherapy.

Ramsay Hunt syndrome usually presents a classic triad of symptoms: ipsilateral facial paralysis, otalgia, and vesicular rash—but the symptoms might vary from person to person. 

The symptoms of Ramsay Hunt syndrome are shingles of the face that cause rash around the face and ears, hearing loss, giddiness, vertigo, and facial paralysis that Justin Bieber has. Because of this, the person affected might be unable to frown, shut his eyes, and smile properly on one side of the face.
Dr. Agni Kumar Bose, Dermatologist, Dr. Rekha Sheth's Clinics
Rashes around the face and ears due to reactivation of varicella-zoster virus infection causing Ramsay Hunt syndrome

One can identify Ramsay Hunt syndrome from various tests like culture tests, PCR testing, ELISA, MRI, and CT scans.

Further in the video, Dr. Agni shared that "the condition might be reversible if the treatment is started within 72 hours and stated that a delay in treatment might make the condition permanent."

Multiple studies suggested the use of antivirals for the treatment of this syndrome with corticosteroids. The course of treatment can be depending on the person's condition and infection. Symptomatic management includes using NSAIDs and long-acting opioids.

The shingles vaccine for older people and the chickenpox vaccine for children can prevent this condition.

At the end of the video, Dr. Agni advised viewers to seek immediate medical advice if they experience any symptoms or the slightest concern.

The varicella-zoster virus's late reactivation is the cause of Ramsay Hunt syndrome. It bears the name of a neurologist and American army officer. There are a majority of factors that might cause the reactivation of the virus, which in turn damages the facial nerve. The symptoms of this syndrome are rashes, facial paralysis, and hearing loss. The best treatment for this would be recognizing it early and treating it with antivirals. Furthermore, vaccinations are another option for avoiding viral infection.

References:

1. Professional, C. C. M. (n.d.-c). Ramsay Hunt Syndrome. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/6093-ramsay-hunt-syndrome

2. Crouch, A. E., Hohman, M. H., Moody, M. P., & Andaloro, C. (2023b, August 28). Ramsay Hunt Syndrome. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK557409/

3. Ramsay Hunt syndrome - Symptoms & causes - Mayo Clinic. (2021, October 12). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/ramsay-hunt-syndrome/symptoms-causes/syc-20351783

By Siddiqua Parveen

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