Causes
Herpes zoster oticus, also known as Ramsay Hunt syndrome, is caused by reactivation of the varicella-zoster virus, which initially causes chickenpox. After primary infection, the virus lies dormant in the sensory ganglia, and it can reemerge later in life, usually affecting the ear and the face.
Symptoms
Herpes zoster oticus may cause the following symptoms:
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Sharp or burning pain in the ear.
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There may be a rash on the ear, inside the ear canal, or on the face near the ear. The rash usually appears as small blisters filled with fluid that burst and crust over.
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There is a partial or complete loss of hearing in the affected ear.
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On the affected side, there is weakness or paralysis of the facial muscles.
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The sensation of dizziness or spinning is known as vertigo.
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There is a ringing or buzzing sensation in the ear known as tinnitus.
Diagnosis
Herpes zoster oticus is typically diagnosed by:
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Examination of the ear, face, and cranial nerves to determine if there are any characteristic symptoms such as rash, facial weakness, and hearing loss.
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Asking about any recent stressors or illnesses that may have triggered the reactivation of chickenpox or shingles.
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To diagnose nerve involvement and rule out other possible causes of symptoms, magnetic resonance imaging (MRI) or computed tomography (CT) scans of the head may be performed.
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Testing for the varicella-zoster virus can be done using polymerase chain reaction (PCR) on fluid from blisters or ear canal swabs.
Treatment
In order to treat herpes zoster oticus, the following steps are usually taken:
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By inhibiting viral replication, antiviral medications such as acyclovir, valacyclovir, or famciclovir are commonly prescribed to reduce the duration and severity of the infection.
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To alleviate ear pain and discomfort, over-the-counter pain relievers or prescription medications can be used.
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Oral corticosteroids may reduce inflammation and swelling of the affected nerve, potentially minimizing the risk of long-term complications.
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Treatment for symptoms may include topical creams or ointments for skin lesions, ear drops for pain relief, and vestibular rehabilitation therapy for vertigo.
Prevention
There are several ways to prevent herpes zoster oticus, including:
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The varicella-zoster virus vaccine is recommended for adults aged 50 and older to prevent shingles and its complications, including herpes zoster oticus.
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Reducing stress and maintaining overall health can reduce the risk of virus reactivation.
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Treatment: Early recognition and treatment of shingles symptoms may help prevent complications such as herpes zoster oticus.
Conclusion
In Ramsay Hunt syndrome, reactivation of the varicella-zoster virus causes herpes zoster oticus, a painful and debilitating condition. In order to alleviate symptoms, reduce complications, and improve outcomes, prompt diagnosis and treatment with antiviral medications and supportive care are essential. In order to reduce the risk of herpes zoster oticus in older adults, vaccination against shingles is an important preventive measure.
