Imagine yourself waking up suddenly, and not being able to close your eyes properly, smile, or even wrinkle your forehead. This may sound like a horrifying nightmare, but it may indicate a sign of an underlying neurological disorder. 

Recently, the renowned Canadian singer, Justin Bieber was diagnosed with a rare neurological disorder, also known as Ramsay Hunt Syndrome (RHS). This rare viral infection has left him paralyzed on one side of his face, causing his world tour to be postponed. 

What is so special about this virus? Is it deadly like COVID-virus? How is this transmitted and is it curable? Let’s find out more below! 

Understanding Ramsay Hunt Syndrome 

Image credit: Mayo clinic

Ramsay Hunt Syndrome (RHS) is a very rare neurological disorder, with an incidence of 5 per 100,000 people per year. A physician named James Ramsay Hunt was the first to describe this disorder in 1907. Ramsay Hunt syndrome is caused by the varicella-zoster virus; which is the same virus that causes chickenpox. 

This neurological disorder can occur in anyone who has had chickenpox in the past and this virus is said to remain in our body even after recovering from the disease itself. The dormant virus in the body becomes reactivated and causes inflammation of the facial nerve that supplies our face and around our eyes. The affected individuals usually experience one-sided facial paralysis and some develop rashes affecting the ears. The inflammation of the facial nerve will result in the facial muscles to become weak or stiff, resulting in the inability to smile, close one eye, or wrinkle the forehead on the affected side of the face.

Other common symptoms may include: 

• Ear pain 

• Ringing in your ears (tinnitus) 

• Hearing loss/ disturbances 

• Difficulty closing one eye which can cause dryness of the affected eye

• The sensation of spinning or moving (vertigo) 

• A change in taste perception or loss of taste

• Dry mouth and eyes

Complications of Ramsay Hunt Syndrome may include permanent hearing loss and facial weakness, eye damage, and postherpetic neuralgia (persistent nerve pain due to shingles infection). It is important to seek treatment as soon as possible to prevent possible complications. 

Is Ramsay Hunt Syndrome Contagious? 

The disease itself is not contagious, however, having this disease means you have the varicella zoster virus activated in your body. Thus, you have the risk of giving someone chickenpox or shingles if he or she has not had a previous infection. It may cause serious complications to certain groups of people, especially someone with a weak immune system, pregnant women, and newborns. It may be necessary to avoid physical contact until the blisters have a dry scab formed over it. 

Can it be cured? 

Ramsay Hunt syndrome is treated with antiviral medications (famciclovir or acyclovir) in conjunction with corticosteroids (i.e. prednisolone). These medications can help to control the viral infection. Starting antiviral therapy within 72 hours of symptom onset has shown to confer the greatest benefit. Higher rate of complete recovery and a significant reduction of complications is observed if proper treatment is given promptly at the right time. 

However, there is no cure for the underlying cause of Ramsay Hunt syndrome, because the cause is unknown. Once you have the varicella-zoster virus, it will remain in your body for the rest of your life. Otherwise, the treatment for RHS is symptomatic and given based on the current symptoms experienced such as painkillers, anti-seizure medications to help reduce neuralgia pain, antihistamines for vertigo symptoms. Affected individuals who are unable to close the eye properly on the affected side have a risk of abnormal exposure of cornea to drying and foreign body irritation, which can result in corneal ulceration. Hence, special care needs to be taken by using artificial tears and lubricating ointments to prevent eye complications.

Are there any home remedies for this?

Absolutely! Some lifestyle changes and home remedies can help strengthen our immune system and prevent flare-ups. 

1. A healthy diet consist of fresh fruits or vegetables 

2. Apply the cool wet compress to raw areas to help ease pain

3. Taking over-the-counter pain medications at first signs of pain

4. Wearing an eye patch to prevent eye damage and help moisturize the eyes throughout the night 

How can I protect myself from this disease? 

Vaccination against chickenpox is recommended for children to reduce the chances of getting infected with varicella zoster. For people aged 50 or older, a shingles vaccine is recommended.

Medically reviewed by Ashwini Nair, MB BCh BAO.

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References: 

1. Ramsay Hunt Syndrome- Mayoclinic. Accessed June 11, 2022. https://www.mayoclinic.org/diseases-conditions/ramsay-hunt-syndrome/symptoms-causes/syc-20351783 

2. Ramsay Hunt Syndrome Treatments and Medications-Singlecare. Accessed June 11, 2022. https://www.singlecare.com/conditions/ramsay-hunt-syndrome-treatment-and-medications 

3. Ramsay Hunt Syndrome-Healthline. Accessed June 11, 2022. https://www.healthline.com/health/ramsay-hunt-syndrome#treatment

4. Ramsay Hunt Syndrome-NORD. Accessed June 11, 2022. https://rarediseases.org/rare-diseases/ramsay-hunt-syndrome/#:~:text=Ramsay%20Hunt%20syndrome%20(RHS)%20is,loss%20may%20also%20be%20present. 

5. Justin Bieber reveals facial paralysis after shows cancelled-BBCNews. Accessed June 11, 2022. https://www.bbc.com/news/world-us-canada-61767457 

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