Ramsay Hunt syndrome

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Hunt's syndrome; Herpes oticus

Treatment with anti-viral medications, such as acyclovir or famciclovir is recommended for 7 - 10 days, along with strong anti-inflammatory drugs called steroids (such as prednisone) for 3 - 5 days.

The steroids are then tapered off in about 1 week. Sometimes strong pain killers are also needed if the pain persists despite the use of the steroids. During the period of facial weakness, an eye patch should be worn to prevent corneal abrasion and damage to the eye if it does not close completely.

If damage to the nerve is minimal, then a full recovery is usually expected within a few weeks. If damage is more severe, there may not be full recovery -- even after several months.

Overall, chances of recovery are better if the treatment is started within 3 days of the onset of the symptoms. Complete recovery is achieved by 70% of patients if treatment is begun at this time.

However, when the treatment is delayed more than 3 days, the chances of complete recovery drop to about 50%. Children are more likely to have a complete recovery than adults.

Recovery may be complicated if the nerve grows back to the wrong areas (synkinesis) which may cause inappropriate responses, such as tears when laughing or chewing (croc´s tears). Some other people may experience blinking of the eye when talking or chewing food.

Severe paralysis will result in incomplete or inappropriate recovery with potential for permanent facial paralysis and synkinesis.

Occasionally, the virus may spread to other nerves or even to the brain and spinal cord, causing headaches, back pain, confusion, lethargy, and limb weakness. This may prompt an admission to the hospital, where a spinal tap may help to determine whether other areas of the nervous system have been infected.

Call your health care provider if you have facial paralysis or a rash on your face associated with facial weakness.

Review Date: 09/25/2006
Reviewed By: Kenneth Gross, M.D., Neurology, North Miami, FL. Review provided by VeriMed Healthcare Network.