Ramsay Hunt syndrome (RHS), also known as herpes zoster oticus, is a complication of varicella-zoster virus (VZV) reactivation in the geniculate ganglion. It is characterized by a painful rash in the ear or mouth, facial paralysis, and sometimes severe vertigo. According to the Mayo Clinic, vertigo can be a prominent early symptom, often mistaken for other inner ear disorders.
Diagnosis is primarily clinical, based on the triad of ear rash, facial weakness, and hearing or balance issues. The National Institute of Neurological Disorders and Stroke (NINDS) notes that prompt treatment with antiviral drugs like acyclovir and corticosteroids can improve outcomes, especially if started within 72 hours of symptom onset.
Vertigo in RHS results from VZV inflammation affecting the vestibular nerve. A 2023 review in the Journal of Neurology found that up to 40% of RHS patients experience vertigo, which can persist for weeks. Management includes antivirals, vestibular suppressants, and physical therapy for balance rehabilitation.
Prevention is possible through the varicella (chickenpox) vaccine and the shingles vaccine (Shingrix), recommended for adults aged 50 and older. The CDC states that Shingrix reduces the risk of shingles and its complications, including RHS, by over 90% in immunocompetent adults.
