Ramsay Hunt Syndrome (cont.)

Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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The classic symptom that clinically distinguishes Ramsay Hunt syndrome is a red painful rash associated with blisters in the ears or mouth and facial paralysis (for example, eyelid or mouth) on one side of the face. Other symptoms such as ear pain, hearing loss, dizziness (or vertigo), dry eye, and changes in taste sensation may also occur.

Diagnosis of the syndrome is most often made by observing the symptoms described above (red painful rash with ear and or mouth blisters and one-sided facial paralysis). Also, a PCR test (polymerase chain reaction) can be performed on the fluid from the blisters to demonstrate the viral genetic material, but this test is not done routinely.

The syndrome is not contagious; however, the herpes zoster virus that can be found in the blisters of Ramsay Hunt syndrome can be transmitted to other people and cause chickenpox in those that are unvaccinated against chickenpox. Individuals with Ramsay Hunt syndrome should avoid contact with newborns, pregnant women, immunodepressed individuals, and people with no history of chickenpox, at least until all the blisters change to scabs.

Bell's palsy also is a result of injury to the facial nerve by virus infection, but the suspected cause of Bell's palsy (viral) has not been identified. Ramsey Hunt syndrome is caused by the Varicella virus (herpes zoster) that also causes chickenpox and shingles (a painful, blister-producing herpes zoster reinfection that usually occurs on one side of the body). There is no red rash associated with Bell's palsy as there is with Ramsey Hunt syndrome. Additionally, Ramsay Hunt syndrome is commonly more painful than Bell's palsy. However, both can cause eyelid and mouth paralysis on one side of the face.

Dyssynergia cerebellaris myoclona is a rare degenerative disease of the nerves characterized by epilepsy, muscle spasms, and gradually increasing tremors. Like Bell's palsy, this disease complex mimics many symptoms of Ramsay Hunt syndrome. Some investigators term the disease complex Ramsay Hunt syndrome type 2.

Source: MedicineNet.com
http://www.medicinenet.com/ramsay_hunt_syndrome/article.htm