Michael Hunter, MD on Medika Life

Justin Bieber: “Harder to Eat” Due to Ramsay Hunt Syndrome

What is this rare neurological syndrome?

THE FAMOUS SINGER HAS A DROOPY HALF OF HIS FACE and received a diagnosis of Ramsay Hunt syndrome earlier this month. It has been a challenging year for the pop star, with his wife suffering from a mini-stoke three months ago.

The 28-year-old singer revealed in an Instagram video that he had been diagnosed with Ramsay Hunt syndrome. The right side of his face is paralyzed, so he cannot close the right eye or even smile with that side of his face.

Let’s briefly look at Ramsay Hunt syndrome, a rare neurological condition.

Ramsay Hunt syndrome symptoms

Ramsay Hunt syndrome happens when a shingles outbreak affects the facial nerve near one of the ears. The possible results?

  • A painful red rash with fluid-filled blisters in, on, or around one ear
  • Hearing loss and facial paralysis in the affected ear. There may also be an ear or mouth rash that can be painful.

The Mayo Clinic (USA) adds the following symptoms:

  • Ear pain
  • Hearing loss
  • Ringing in your ears (tinnitus)
  • Difficulty closing one eye
  • A sensation of spinning or moving (vertigo)
  • Taste perception change or loss
  • Dry eyes and mouth

Ramsay Hunt syndrome causes

Ramsay Hunt syndrome is caused by the varicella-zoster virus (VZV), which causes chickenpox in children and shingles (herpes zoster) in adults. After chickenpox resolves, the virus still lives in your nerves. Many years later, it may reactivate and affect your facial nerves.


“The nerves that go through your face go through pretty narrow, bony canals, and when they’re inflamed they swell and lose the ability to function,” said Dr. Anna Wald, an infectious disease specialist at the University of Washington School of Medicine (USA).

Writing in the New York Times, Dr. Waleed Javaid, director of infection prevention and control at Mount Sinai Downtown in New York City, offers that “only approximately five to 10 out of every 100,000 people get Ramsay Hunt syndrome each year.” He adds that “it can happen to anyone.

Doctors usually diagnose Ramsay Hunt syndrome by identifying small blisters in a patient’s ear.

Potential long-term consequences of Ramsay Hunt syndrome

  • Permanent hearing loss and facial weakness. For most individuals, hearing loss and facial paralysis are temporary.
  • Eye damage. Facial weakness CA may make it difficult for you to close your eyelid. The cornea, which protects your eye, can then become damaged. This damage can cause blurred vision and eye pain.
  • Postherpetic neuralgia. The signals sent by these nerve fibers become confused and exaggerated, causing pain that may last long after other Ramsay Hunt syndrome symptoms have resolved.

Ramsay Hunt syndrome management

Prompt treatment of Ramsay Hunt syndrome can lower the chances of long-term complications, including permanent facial muscle weakness and deafness.

Ramsay Hunt medications may include:

  • Antiviral drugs. Acyclovir (Zovirax), famciclovir (Famvir), or valacyclovir (Valtrex) often help.
  • Corticosteroids. A short course of high-dose prednisone may boost the effect of antiviral drugs.
  • Anti-anxiety medications. Diazepam (Valium) and similar drugs may provide relief.
  • Pain relievers. Given the pain can be severe, prescription pain medications are sometimes needed.
Photo by Sasun Bughdaryan on Unsplash

Home remedies for Ramsay Hunt syndrome

The Mayo Clinic offers some suggestions for symptom management. These include:

  • Keep rash areas clean.
  • Apply cool, wet compresses to the rash for pain relief.
  • Take an over-the-counter pain reliever, such as ibuprofen (Advil, Motrin IB, others).

If facial weakness makes it challenging for you to close an eye, protect your vision:

  • Use moisturizing eye drops throughout the day if your eye becomes dry.
  • At night, apply ointment to the eye, tape your eyelid shut, or wear an eye patch.

Ramsay Hunt prognosis

Fortunately, most individuals with Ramsay Hunt recover fully. Still, the disease’s duration varies among individuals, according to Dr. Michael Ison, a professor of infectious diseases at Northwestern Feinberg School of Medicine (USA).

Dr. Ison explains: “For some people, it takes weeks. Some people, it takes months,” he explains. Rarely, facial paralysis or hearing loss can be permanent.


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Michael Hunter, MD
Michael Hunter, MD
I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

Michael Hunter, MD

I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

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