Ramsay Hunt Syndrome: our Physiotherapist explains

What is Ramsay Hunt Syndrome?

Ramsay Hunt Syndrome is a neurological condition caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox and shingles. When this virus hits the facial nerve, it can cause paralysis on one side of the face, intense pain in the ear and painful skin rashes. It is considered one of the most serious causes of peripheral facial paralysis and requires rapid treatment for best results.

What are the main symptoms of Ramsay Hunt Syndrome?

The most common symptoms include severe pain in the ear, a rash with small blisters on the pinna, inside the ear canal or inside the mouth, unilateral facial paralysis, difficulty closing the eye, loss of taste, vertigo, hearing loss and tinnitus. In some cases, the rash may not appear, which makes diagnosis difficult. The rapid appearance of these signs is an important warning to seek immediate medical attention.

What causes this syndrome?

The cause is the reactivation of the varicella-zoster virus, which remains dormant in the nerve ganglia after a person has had chickenpox. When the virus reactivates, it can affect the facial nerve and surrounding structures, causing inflammation, pain and loss of motor function. Factors such as stress, low immunity, advanced age and chronic illnesses can increase the risk of viral reactivation.

Is Ramsay Hunt Syndrome contagious?

The syndrome itself is not contagious, but the varicella-zoster virus can be transmitted to people who have never had chickenpox or who have not been vaccinated. In these cases, the person exposed does not develop the syndrome, but can develop chickenpox. Blisters in the ear or on the skin are the main source of infection, which is why it's important to protect them and follow medical recommendations.

How is the diagnosis made?

Diagnosis is based on a combination of clinical symptoms such as pain in the ear, facial paralysis and characteristic skin rashes. The doctor can carry out complementary tests, such as electromyography, to assess the severity of the facial nerve damage. In some cases, laboratory tests can help confirm the presence of the varicella-zooster virus.

What is the recommended treatment?

Treatment should be started as soon as possible. It includes antivirals and corticoids, drugs to reduce inflammation and painkillers to control pain. The aim is to limit the progression of nerve damage and relieve symptoms. The sooner treatment is started, the greater the likelihood of complete recovery.

Is specialised physiotherapy important in Ramsay Hunt Syndrome?

Yes, physiotherapy specialising in facial paralysis is essential. After controlling the acute phase, the physiotherapist works on recovering facial mobility, motor re-education and preventing sequelae such as synkinesis, contractures and spasms. Techniques such as facial massage, manual therapy, muscle relaxation and coordination training are fundamental to recovering facial symmetry and function.

How long does recovery take?

Recovery varies significantly from person to person. In many cases, there is gradual improvement in the first few weeks. However, Ramsay Hunt Syndrome tends to have a more guarded prognosis than Bell's Palsy, and it can take months to fully recover. In more serious situations, sequelae may persist. Regular monitoring by a specialised physiotherapist contributes to better results.

What are the possible complications?

Among the most common complications are synkinesis, persistent neuropathic pain, prolonged facial weakness, difficulty closing the eye, sound hypersensitivity, tinnitus and vertigo. Early intervention, both medical and physiotherapeutic, substantially reduces the risk of these sequelae.

When should I seek medical help?

It is essential to seek medical help as soon as severe ear pain, facial paralysis, skin rashes or any combination of these symptoms appear. Early diagnosis and prompt treatment are key to improving the prognosis and reducing the likelihood of complications.

Ramsay Hunt Syndrome is a complex condition that requires immediate attention, rigorous diagnosis and specialised follow-up. The sooner corticosteroids and antivirals, pain control and specialised physiotherapy are started, the greater the chances of recovering facial function and avoiding lasting sequelae. At Integrativa, you'll find physiotherapy specialising in recovery from facial paralysis. If you are experiencing symptoms of facial paralysis or suspect Ramsay Hunt Syndrome, seek professional assessment as soon as possible. Early intervention makes all the difference and can be decisive for your recovery and quality of life.