What are the clinical features of Ramsay Hunt syndrome?

The patient will have a shingles rash, to start. Ramsay Hunt syndrome is when the patient has a shingles rash that has also affected a facial nerve near the ear. This means the shingles rash also appears near that ear.

There will be pain in that ear, but little else going on around the face, painwise. If it’s not treated right away, the patient could be paralyzed at that nerve and lose the hearing in the affected ear.

The most obvious signs of Ramsay Hunt syndrome are a painful rash with fluid-filled blisters on and around the affected ear as well as facial weakness or paralysis on that side of the face. Other symptoms include a ringing in the ears, difficulty closing one eye, and dry mouth and eyes.

Patient has deep seated pain in the affected ear. the pain is intermittent in nature, radiating towards the pinna of the ear. there is associated diffuse dull aching background pain. patients also give history of exposure to varicella virus infections (chicken pox). the classic ramsay hunt syndrome is associated with 1. pain in the ear, 2. vertigo and ipsilateral hearing loss, 3. tinnitus, and 4. facial palsy (lmn type). rash or blisters can also be seen along the distribution of nervus intermedius. these herpetic blisters in the external auditory canal may become secondarily infected causing cellulitis.