Ramsey Hunt Syndrome has been in the news recently with the singer Justin Beiber being diagnosed with it in June 2022. Knowing a few patients with the debilitating condition it seemed like a good time to write a blog about what it is and how neuro physiotherapy can help anyone suffering from it.
Ramsey Hunt is a neurological condition that affects adults (commonly those over the age of 60). It is caused by the same virus that causes chicken pox in children and shingles in adults, Varicella Zoster Virus. Following chicken pox in childhood the virus can lay dormant until it is reactivated causing shingles, if it affects the facial nerve then it is called Ramsey Hunt Syndrome. The virus can become reactivated when your immunity is low and less able to fight off infection, stress can often be a cause of weakened immunity and therefore Shingles and Ramsey Hunt can be triggered by a period of significant stress. In Ramsey Hunt the reactivated virus causes irritation and swelling to the facial nerve leading to facial weakness. Due to the close proximity of the facial nerve to the nerves of balance and hearing it is also possible to experience loss of hearing and balance/dizziness problems associated with Ramsey Hunt Syndrome.
You can’t catch Ramsey Hunt Syndrome from anyone, however if you have no immunity to chicken pox (no childhood exposure or vaccination) then you can catch chicken pox from someone with Ramsey Hunt Syndrome if in contact with an open blister.
Ramsey Hunt typically presents with a rash or blisters around the ear and scalp on the affected side and can cause blisters inside the mouth. Weakness in the face can lead to difficulty closing your eye and blinking, smiling, and eating and sometimes causes changes in taste. You might also lose hearing on the affected side and experience problems with getting dizzy and being off balance. Although it doesn’t directly affect your ability to speech the weakness in the lips and cheek muscles can make forming some sounds difficult.
Urgent treatment at onset of symptoms can be critical to improving the outcome of your facial palsy ideally early diagnosis and starting anti-viral medication and steroids with-in 72 hours can help limit the extent of the facial weakness. It is also very important to get urgent advice on eye care to avoid damage to the eyeball due to limited blinking.
The outcome depends on the severity of the facial weakness and speed of recovery. Once you’ve accessed urgent medical care for diagnosis and timely management of the condition then it’s time to start physiotherapy to learn what is best to do in the management of facial palsy and how to help ensure you make steady progress with exercises to maximise your recovery and limit complications.
Physiotherapy can also help if you have issues with dizziness and poor balance by providing an individual exercise programme to help improve the function of your balance systems.
Ramsay Hunt Syndrome – NORD (National Organization for Rare Disorders) (rarediseases.org)
Ramsay Hunt Syndrome – Facial Palsy UK