Ramsay Hunt syndrome is a set of symptoms caused by the shingles virus. The virus infects a specific set of nerves that affect the ear, mouth, skin, and muscles of the face, neck, and scalp. The virus is the same virus that causes chickenpox.

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The chickenpox virus remains in the body, even after the illness has passed. In some, this virus can reactivate and cause shingles, an infection that causes inflammation along certain nerves.

With Ramsay Hunt, the infection affects a specific set of facial nerves that can affect the ear, mouth, face, neck, and scalp.

Risk Factors

Factors that may increase your chance of Ramsay Hunt syndrome include:

  • Having shingles or history of chickenpox
  • Weakened immune system
  • Family history of shingles


Ramsay Hunt syndrome may cause:

  • Painful, one-sided red rash in the ear, mouth, or on the tongue
  • One-sided facial paralysis, with or without a rash—Bell’s palsy
  • Dry mouth and/or eyes
  • Loss of taste
  • Hearing loss
  • Ringing in the ear—tinnitus
  • Nausea or vomiting
  • A sensation of spinning while standing still—vertigo
  • Involuntary eye movement—nystagmus


You will be asked about your symptoms and medical history. A physical exam will be done. A diagnosis can often be made based on history and physical exam.

Lab tests may need to be done to confirm shingles or identify other infectious causes.


Treatment for milder symptoms is usually not needed. For moderate or severe symptoms medication may be needed to reduce the intensity or duration of symptoms. Options include:

  • Antiviral medication—may shorten the duration of the infection when taken early
  • Corticosteroids—to reduce inflammation around the nerve
  • Benzodiazepines—to reduce vertigo symptoms
  • Pain medication

Other treatments are based on the symptoms that are present. Eye care may be needed if the infection is making it difficult to completely close your eyes.


The herpes zoster vaccine may decrease the likelihood of getting shingles, including Ramsay Hunt syndrome.

The vaccine is recommended for most people aged 50 years and older. It is important to note that people with a weakend immune system have a higher risk of developing shingles.