Ramsay Hunt syndrome

Ramsay Hunt syndrome happens when the varicella-zoster virus — the same one behind chickenpox and shingles — reactivates near the facial nerve. The result is facial paralysis, usually with real pain in or around the ear.

The telltale sign is a blistering rash in or around the ear, and sometimes on the roof of the mouth or the tongue. But not everyone gets a visible rash, which is why the ear pain itself is worth taking seriously.

Ear pain and rash are what separate Ramsay Hunt from Bell’s palsy — and the distinction changes the treatment. Ramsay Hunt is treated with antiviral medication, usually alongside steroids, and starting early makes a real difference.

So if you have facial weakness and your ear hurts, or you spot any blisters near it, say so to your doctor explicitly. It’s a small detail that meaningfully changes your care.

Because the virus is active right next to the hearing and balance nerves, some people also notice hearing loss, ringing in the ears, or dizziness.

Mention any of these to your doctor — they help confirm what’s going on and shape follow-up care, including whether a hearing check is worthwhile.

Recovery from Ramsay Hunt tends to be slower than Bell’s palsy, and early antiviral treatment is one of the few things known to improve the odds. If this page sounds like you, don’t wait to be sure — get seen today.

The same eye rule applies here: if the eye can’t close fully, protect it with drops, ointment, and night taping from the very start.