Article Text

Download PDFPDF
Ramsay Hunt syndrome
  1. Martha R Neagu,
  2. Sashank Prasad
  1. Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Sashank Prasad, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA; sprasad2{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

A 66-year-old man presented with complete right facial paralysis (figure 1). Three days before, he had experienced a burning sensation in the right ear and developed oral lesions. On examination, there was a peripheral right facial palsy with hyperacusis and loss of taste sensation. He had herpetic vesicles on the right anterior tongue and palate (figure 1). We diagnosed Ramsay Hunt syndrome. Following treatment with valacyclovir and corticosteroids, he made a near-complete recovery.

Figure 1

Ramsay Hunt Syndrome. (A) Complete right facial palsy. (B) Vesicular rash on …

View Full Text


  • Contributors MRN provided clinical care and drafted the manuscript. SP provided mentorship and revised the manuscript for intellectual content.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Referee's commentary Neagu and Prasad provide a neat and valuable lesson in facial nerve anatomy, based on the distribution of the rash in a patient with a lower motor neurone facial nerve palsy associated with herpes zoster infection. The viral infection elegantly uncovers areas, not routinely tested on clinical examination, as belonging to the boundary zones of the involved facial nerve. This is a compelling example of a treatable disease briefly delineating, for observant clinicians, the normal but little known anatomy of an otherwise familiar nerve. Tom Hughes, Cardiff, UK

Linked Articles

  • Image of the moment
    Altaf Saadi Brett McCray Erik Ensrud Sashank Prasad

Other content recommended for you