What is the difference between bell palsy and ramsay hunt

Most patients complete their recovery within one year, and often within several weeks to a few months when the paralysis is incomplete and the patient is young and healthy. Other than the presenting symptoms of pain, rash, facial paralysis, dysgeusia, hearing loss, tinnitus, vertigo, hoarseness, dysarthria and others mentioned above, short-term complications of Ramsay Hunt syndrome include corneal abrasion and exposure keratopathy, depression and social anxiety, and transmission of chickenpox to unvaccinated or immunocompromised close contacts.

While flaccid paralysis in the long-term is unlikely, development of synkinesis is very common. While Ramsay Hunt syndrome is ideally managed pharmacologically by a primary care provider, specialist consultation to a physician with acute facial paralysis experience may be valuable.

An otolaryngologist or facial plastic surgeon may be more familiar with the treatment of Ramsay Hunt syndrome than a general practitioner, and is more likely to have easy access to audiometry and flexible fiberoptic laryngoscopy.

A neurologist is also helpful in the evaluation of cranial neuropathies and treatment of chronic neuralgia, and may be able to provide electrodiagnostic testing for patients with complete hemifacial paralysis.

An ophthalmologist can evaluate the health of the cornea with slit lamp examination and fluorescein dye, and both the ophthalmologist and the otolaryngologist should be capable of placing an eyelid weight, if necessary. An internist or endocrinologist may be required to manage blood glucose levels during prolonged high-dose steroid administration, and lastly, some patients will require consultation with a behavioral health specialist to assist with management of mood symptoms and anxiety that stem from facial dysfunction.

When discussing Ramsay Hunt sydrome with patients, it is important to emphasize that everyone gets better, but not everyone gets all the way better. Perhaps even more crucial is impressing upon patients the importance corneal protection during the period of flaccid paralysis, because the temporary nature of the facial palsy does not preclude the possibility of sustaining a permanent ocular injury during that interval.

Accordingly, the application of artificial tears throughout the day and ocular lubricant ointment at night, and the use of eyelid stretching and taping can mean the difference between a satisfactory long-term outcome and an unsatisfactory one.

It is also important for patients with active vesicles to avoid contact with unvaccinated and immunocompromised individuals, as they can spread varicella zoster virus from their lesions.

It is also important to remember that while most patients will not develop either chickepox or zoster more than once, it has been reported, particularly in immunocompromised individuals.

Ramsay Hunt syndrome affects patients in myriad ways, with pain, paralysis, cochleovestibular symptoms, and behavioral health concerns all occurring commonly in the acute period. In the long term, while most patients do recover the majority of their premorbid function when managed appropriately, pain, facial dysfunction, scarring, and behavioral health concerns may all persist.

For this reason, optimal patient outcomes occur when healthcare teams include members with expertise across a broad range of specialties. Patients who develop synkinses may require regular visits over the course of years and years with a physician or nurse who can administer botulinum toxin injections; it is critical to surround these patients with an experienced interprofessional team early on in the treatment process in order to provide them the care and support they need to maximize quality of life outcomes.

Revista da Associacao Medica Brasileira Journal of neurology, neurosurgery, and psychiatry. World neurosurgery. Indian journal of palliative care. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences. The Pediatric infectious disease journal. Annals of neurology. American family physician.

The Laryngoscope. The Permanente journal. BMJ case reports. Iranian journal of otorhinolaryngology. The American journal of case reports. Quintessence international Berlin, Germany : Acta oto-rhino-laryngologica Belgica. International archives of otorhinolaryngology.

The New England journal of medicine. Clinical otolaryngology and allied sciences. The latter is also the nerve which controls nose moisture and formation of tears for the eye. Where these nerves are together in the internal ear canal, they float in cerebrospinal fluid. At the lateral end of the internal ear canal, the hearing and balance nerves enter the inner ear, but the facial nerve and the nervus intermedius join together to course just above the inner ear.

At this location, there are at least two nerve junction and cell body or ganglion areas. The one considered most likely the source of critical swelling is the ganglion of the meatal foramen. In this region of the facial nerve, a leathery brain covering wraps the nerve pretty tightly to prevent spinal fluid from leaking out along the nerve.

The tightly wrapped nerve then enters the bony nerve canal which is barely large enough for a not-swollen nerve. Anatomic research suggests that the tighter this bony canal is, the less it allows a nerve to swell without compromising its function. In children, the bony canal is larger relative to nerve size than in adults. In some adults, the nerve just barely fits into the bony canal, leaving no room to tolerate nerve swelling during a viral nerve inflammation.

In pregnancy, the natural tendency to retain fluid makes this situation more difficult. In a stroke-associated facial palsy, the forehead generally is still active. This is called forehead sparing. Such a stroke comes from the opposite side of the brain. The sparing occurs because some forehead nerve fibers come from the same side of the brain or do not crossover. This particular organism is transmitted by the deer tick and is not endemic or does not exist in mid to South Florida.

Along the entire Gulf of Mexico coastline, a Lone-Star Texas tick may transmit a similar spirochete capable of doing the same. The same blood tests for Lyme disease are positive in both cases but Lyme disease facial paralysis is quite rare in those who have not been out of Florida in the spring to early summer when the nymph deer ticks are most likely to infect folks. In Lyme disease, the facial paralysis may occur at virtually any future date, but generally does so within a few seasons of the initial contact.

Facial palsy from Lyme disease appears more likely to affect both sides of the face and is more common in children. Among the more critical to recognize are ear infection related facial palsy. The latter is more common in children more prone to acute middle ear infection, but may also occur at any age with a specific ear problem called infected cholesteatoma. A variety of tumors can also cause facial paralysis, generally taking 4 or more days to develop.

Another rare, sometimes relapsing problem is called Melkerson-Rosenthal syndrome. In this disorder, along with facial paralysis, the patient also develops a swollen, coated tongue at the onset of the Palsy and typically swelling in the face. This disorder may be recurring as well.

Call your doctor if you experience facial paralysis or a shingles rash on your face. Treatment that starts within three days of the start of signs and symptoms may help prevent long-term complications. Ramsay Hunt syndrome occurs in people who've had chickenpox.

Once you recover from chickenpox, the virus stays in your body — sometimes reactivating in later years to cause shingles, a painful rash with fluid-filled blisters. Ramsay Hunt syndrome is a shingles outbreak that affects the facial nerve near one of your ears. It can also causes one-sided facial paralysis and hearing loss. Ramsay Hunt syndrome can occur in anyone who has had chickenpox.

It's more common in older adults, typically affecting people older than Ramsay Hunt syndrome is rare in children. Ramsay Hunt syndrome isn't contagious. However, reactivation of the varicella-zoster virus can cause chickenpox in people who haven't previously had chickenpox or been vaccinated for it. The infection can be serious for people who have immune system problems. Children are now routinely vaccinated against chickenpox, which greatly reduces the chances of becoming infected with the chickenpox virus.

Join for free today. Join Now. What is Ramsay Hunt syndrome? What causes the shingles virus VZV to reactivate? At times our immune system becomes depressed and is less able to fight off infection.

The body then becomes vulnerable to reactivation of the chickenpox virus. Stress is often a trigger. Many studies have shown that stress can weaken the immune system, and that people under significant stress are more likely to suffer from infections than those who are not. For this reason, it is believed that stress can be linked to outbreaks of shingles, and thus RHS could result. What are the symptoms of Ramsay Hunt syndrome? A rash or blisters in or around the ear, scalp or hair line.

The blisters may also appear inside the mouth. Weakness on the affected side of your face which causes the facial muscles to droop. Difficulty closing the eye or blinking on the affected side. Altered taste on the affected half of the tongue. Loss of facial expression on the affected side. Difficulty eating, drinking and speaking as a result of weakness in the lip and cheek on the affected side.

Ear, face or head pain. You cannot catch RHS from an infected person.