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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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What are the odds of full recovery from ramsey hunt syndrome

Customer Question

what are the odds of full recovery from ramsey hunt syndrome type II? What is the durartion of recovery time from r h II?
JA: The Neurologist will need to help you with this. Please give me a bit more information, so the Neurologist can help you best.
Customer: My son-in-law came down with the first symptoms last Friday, a severe ear ache. He saw a Dr. within hours who put him on antibiotics. Over the weekend he presented blistering around his ear and on his face, as well as nausea, paralysis on the right side of his face,and vertigo (I am not sure in what order each of these new symptoms occurred). He saw another Dr. I believe an ENT) on Monday who diagnosed the problem as Ramsey Hunt Syndrome II, and put him on both Valtiex and Predisone. By Monday evening his vertigo and his nausea had subsided a bit, and his ear opening, which had swollen shut over the weekend. On Monday afternoon Dr. saw no new blisters forming in the ear canal. Finally, for the past 72 hours he cannot close one eylid; that has not changed.
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Customer: Yes.
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Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Hello. Welcome to JA. I will review your statement and reply shortly. Please read this preliminary answer and respond if you have questions Dr Frank

Expert:  Dr. Frank replied 1 year ago.

I will first attach a review article about Herpes Zoster Infections in the CNS, which includes some information with references about Ramsay Hunt Syndrome (Type II is the otitis problem, Type I is a rare form of epilepsy, not related to viral infections)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2754837/

Expert:  Dr. Frank replied 1 year ago.

To answer your specific questions. One of the problems with Zoster infection in the geniculate ganglion, the ganglion associated with the facial nerve, is that the virus has a tendency to cause havoc because it is a hemorrhagic virus, it causes little microbleeds within the ganglion, which can eventually scar and cause permanent deficits in function. So the bot***** *****ne to your son's problem is that it is not certain that he will get complete recovery of his facial weakness, or his vertigo. Exactly what are the odds?, Studies have shown that time is of an essence in getting treated with steroids and anti-viral agents, both which he received within days of infection. In studies of regular Bell's palsy, (meaning from a non-zoster virus, no blistering, etc) there was debate as to whether steroids helped in recovery and residual deficits, and it was determined that they were helpful and it became essential to start them, usually within the first 24 hours of onset. I would think that applies as well to RHS, that you want the steroid effect as soon as possible in the course of the disease. I will try to find more data on studies as to recovery from RHS and post it for you. Please get back to me with questions and I will reply Dr Frank

Expert:  Dr. Frank replied 1 year ago.

Here is another article that gives a lot more information on VZV infections, including ramsay hunt. It talks about the hemmorhagic nature, and how prognosis is attached to speed of diagnosis and treatment. Please get back to me to discuss this further if I can help, or if satisfied with this answer, please remember to rate this service by clicking on the rating stars, as that is how I am compensated for this work thanks dr Frank

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4051361/