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Ramsay Hunt Syndrome (RHS) denotes itself as a facial paralysis followed by mouth and ear rashes. Herpes Zoster Oticus is another term for the replacement of Ramsay Hunt Syndrome. The disease is contagious; hence, it can pass one to another. 

The appearance of this disease often dominated by the proliferation of Varicella-Zoster Virus (VZV) at geniculate ganglion. The time the virus becomes active, the inflammation keeps happening to the affected area. As an outcome, herpetic inflammatory lesion makes its presence.  

VZV ensues myriads of clinical presentations on different sites of the body. Those clinical presentations could be acute enough to make you a psychologically distressed person. Psychological issues significantly decrease the fighting ability of the immune system. The reduced function of the immune system allows the VZV to thrive freely.

Reports suggest that Ramsay Hunt Syndrome typically attacks immunocompetent elderly individuals. The disease characteristically involves Ear Canal (external auditory meatus), anterior faucial pillars, Tongue, Eye, and Facial Muscles. It may also affect body parts that did not make their part in our listicle. 

Characteristic Symptoms Of Ramsay Hunt Syndrome (RHS Disease)

Varicella-Zoster Virus (VZV) belongs to the Herpes Virus family; hence, it manifests some characteristic symptoms. How severe the symptoms exhibit entirely relies on an individual’s immune response. Following are the Ramsay Hunt Syndrome symptoms that you need to take into account. 

Pain and rashes are predictable in most of the cases with Ramsay Hunt Syndrome. 
As being a Human herpes virus, it can exhibit fluid-filled blisters in or around your ear and face. 
Unilateral Facial Paralysis is a typical symptom of Herpes Zoster Oticus. 
Feeling of weak facial muscle may indicate the presence of Herpes VZV. 
Since it affects your tongue, it is likely to experience the disappearance of your taste. 
The symptom may also present as a perception of noise. 
It can make people feel nauseous, and vomiting tendency may also occur. 

The Consequences of Ramsay Hunt Syndrome (RHS Disease)

Our Herpes Cure Care team carefully examined some real-life cases of Ramsay Hunt Syndrome Type 2 (Herpes Zoster Oticus). We observed that it is an unusual infection as merely 3 to 4 cases seen per 1000 individuals. Furthermore, facial involvement is seen only in 1 percent of patients. 

Despite being a rare health condition, it can underlay dire consequences. Our observation concludes that if the Herpes Zoster Oticus is severe, it could be fatal. It can exhibit a broad spectrum of sequelae by involving myriads of body parts. 

The collected data suggest that Varicella-Zoster Virus often cause irreversible facial paralysis. Atraumatic facial paralysis more frequently found in patients with RHS Disease.  

James Ramsay Hunt is the man who first described the Ramsay disease in 1907. In the same year, Sir James Ramsay Hunt found an apparent connection between VZV and ear. 

He found that the Varicella-Zoster Virus significantly affects the ear canal, leaving individuals with hearing impairment. The virus may also cause tinnitus (A perception of noise in the ear). Disseminated Varicella-Zoster Virus may even cause complete hearing loss.

Central Nervous System Dissemination Of VZV

VZV rarely disseminates to CNS (Central Nervous System) but, once it intrudes CNS, it can be appalling. The function of the central nervous system may start deteriorating and may cause irreversible damage to cerebral arteries. 

VZV, in its severe form, can cause brain ischemia and Intracerebral hemorrhage.  

It has now an established theory that an immunocompetent individual may develop encephalitis. Aids can remarkably deplete CD4+ T cells and eventually be a prime reason for VZV Encephalitis. The death rate due to VZV encephalitis differs 0 to 25 percent with a 10 % average death rate. 

Varicella vaccine can prevent all consequences listed above.

 Fact – All the herpes viruses that infect Human beings, Varicella Zoster Virus is the only strain that recreates its DNA in arteries. No Herpes viruses can do that.

Herpes Zoster Oticus can even promote some eye complications. The patient may find it difficult or may not be able to blink an eyelid. Corneal damage could also make a way during the reactivation of VZV. 

Diagnosis – Ramsay Hunt Syndrome Type 2

Ramsay Hunt Syndrome is often misunderstood with Bell’s Palsy as it exhibits similar clinical manifestations. Hence, an accurate diagnosis should be a top priority. 

Your physician may be able to quickly diagnose Herpes Zoster Oticus just by seeing signs and symptoms. If clinical symptoms are not upto the mark to recognize it, your physician will rely on the fluid swap. 

Some laboratory tests, including WBC count Serum Electrolytes and ESR, can determine the nature of RHS disease. 

PCR test (Polymerase Chain Reaction Test), Tzanck test, Viral Culture Test, and Antibody Detection test may help in the diagnosis process. 

Sometimes Varicella-Zoster Virus contaminates cerebrum area. In this case, Spinal fluid examination is must to detect the virus invasion 

3 Tesla MRI and magnetic resonance are some imaging-based diagnostic methods that may detect the presence of VZV. 

Preventive Measures of Ramsay Hunt Syndrome

Herpes Virus is obstinate and cannot be defeated for good. Present treatment methods only work by suppressing signs and symptoms of RHS. For the reason that it has no cure, you certainly don’t want to be the victim of this evil reputed virus. 

We have done extensive research on how Ramsay Hunt Syndrome can be prevented. We thoroughly examined the recommendations presented by the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) for controlling the VZV spread. If you are susceptible to Varicella-zoster virus, follow these recommendations.

Varicella Vaccination

Immunization or obtaining vaccination for Varicella Zoster Virus is the most effective way to keep the virus at bay. Since the introduction of the VZV vaccine, a remarkable decrease seen in VZV borne diseases. It estimates that nearly 90 million doses of Varicella vaccines used to date, and the data is continuously increasing. 

Oka strain is a live-attenuate for the development of the Varicella vaccine. Oka Strain was taken from a three years Japanese boy. Clinical trials suggest that the VZV vaccine provides promising protection against severe to moderate Ramsay Hunt Syndrome.

Fact Sheet – Among eight types of Human Herpes Virus, VZV is the only virus for which a vaccination licensed.

Two immunizations with VZV vaccine is relatively providing more protection than getting single Varicella vaccine. 

Shingrix and Zostavax have approved Varicella Vaccines that offer protection against VZV. The Center for Disease Control and Prevention recommends Shingrix as a primary immunization agent. 

The Role Of VZIG

Varicella-Zoster Immune Globulin (VZIG) is an immune rectifying agent, primarily used post-exposure to Varicella-Zoster Virus. Blood and antibodies are two constituents used to formulate VZIG. It is used as a prophylaxis to prevent and modify the severity of the disease. 

Immunocompromised patients get significant protection from diseases caused by VZV. If an individual inadvertently exposed to a person with visible clinical manifestation of VZV, then VZIG must be taken. However, Varicella-Zoster Immune Globulin provides a short term of protection than Varicella Vaccine. According to the CDC, VZIG protection lasts for nearly three weeks; hence, it should be taken every 2-3 weeks. 

Ramsay Hunt Syndrome Treatment and Management

After analyzing numerous realistic cases of Herpes Zoster Oticus, we conclude that initiating the prompt treatment for RHS is necessary. The earlier you start the treatment procedure, the more chances you give yourself for a complete recovery. The significance of the right treatment regimen is also worth keeping in mind.  

The treatment of Ramsay Hunt Syndrome usually consists of Analgesics, Steroids, and Antivirals. You may be prescribed with high doses of Steroids with antiviral agents, especially Acyclovir to tackle RHS entity. Studies found that antivirals, along with high doses of steroids, increases the chance of complete recovery by manifolds. To reduce pain, you may be prescribed with an analgesic. 

Acyclovir received approval for the treatment of RHS in 1992 by the FDA. Since then, it has become a primary treatment entity for tacking different stages of Herpes Zoster Oticus. Other antiviral agents, including Famciclovir and Valacyclovir, have also shown significant recovery rate. 

In the case where the patient can’t blink eyelid may need an injection of Botox to

As we mentioned earlier, prompt treatment is necessary for RHS. Failing in that could cause permanent nerve damage, and full recovery chances will fall severely. 

If treatment initiated promptly, the patient might take several weeks or even months to gain recovery. 

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