Otology A15


Ramsay Hunt syndrome type II

Ramsay Hunt syndrome type II is a reactivation of varicella zoster virus in the geniculate ganglion. It presents with unilateral acute facial nerve paralysis, otalgia, loss of taste in the anterior two-thirds of the tongue, dry mouth and eyes, and an erythematous vesicular rash in the ear canal, tongue, and/or palate. It may also be associated with tinnitus, hearing loss, vertigo, and numbness of the face. It is managed with 7 days of high dose (60mg) prednisolone (with gastric protection) and aciclovir.

Ramsay Hunt syndrome type I is characterised by myoclonus epilepsy, intension tremor, progressive ataxia and some cognitive impairment. It is completely unrelated to Ramsay Hunt syndrome type II (herpes zoster oticus) except for the shared name as both syndromes were first described by the neurologist James Ramsay Hunt.

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