by EBSCO Medical Review Board
(Herpes Zoster Oticus)


Ramsay Hunt syndrome (RHS) is a problem moving the muscles on one side of the face. It also results in a rash around the ear or mouth. It is not common.

Facial Nerve Innervation
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RHS is caused by the varicella zoster virus (VZV). The virus is the same one that causes chickenpox and shingles . It stays in the body even after the illness has passed. In some people, it can reactivate and cause RHS.

Risk Factors

Things that may raise the risk of this problem are:

  • Having shingles or a history of chickenpox
  • A weakened immune system
  • Having other family members who have had shingles


Problems may be:

  • Painful, one-sided red rash in the ear, mouth, or on the tongue
  • Problems moving one side of the face, with or without a rash
  • Dry mouth and eyes
  • Loss of taste
  • Problems hearing
  • Ringing in the ear
  • Nausea or vomiting
  • A feeling of spinning while standing still
  • Eyes that move without control


You will be asked about your symptoms and health history. A physical exam will be done. This is often enough to make the diagnosis.

Lab tests may need to be done to confirm a diagnosis that is not certain.


The goal of treatment is to ease discomfort and quicken recovery. Choices are:

  • Antiviral medicine to shorten the length of time of the infection if taken early
  • Corticosteroids to ease inflammation
  • Benzodiazepines to ease the feeling of spinning
  • Pain medicine


This risk of this problem may be lowered by getting the herpes zoster vaccine.


National Institute of Neurological Diseases and Stroke 

National Organization for Rare Disorders 


Canadian Neurological Sciences Federation 

Health Canada 


About shingles (herpes zoster). Centers for Disease Control and Prevention website. Available at: Accessed January 12, 2021.

Herpes zoster. EBSCO DynaMed website. Available at: Accessed January 12, 2021.

NINDS herpes zoster oticus information page. National Institute of Neurological Diseases and Stroke website. Available at: Accessed January 12, 2021.

Schmader K. Herpes Zoster. Ann Intern Med. 2018 Aug 7;169(3):ITC19-ITC31.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 12/2020
  • Update Date: 01/12/2021