Ramsay Hunt Syndrome

This condition affects the external auditory canal and is associated with the following symptom complexes:
1. Herpetic blisters in the external auditory canal
2. Lower motor neuron facial palsy
3. Otalgia

This patient shows manifestations of right lower motor neuron type of facial palsy. The features include: Inability to close the right eye, deviation of angle to mouth to the left side, loss of wrinkling over right forehead. In upper motor neuron type of facial palsy wrinkling of forehead will be present.

1. Steps towards alleviating pain: Carbamazepine can be prescribed in doses of 400 mg / day in divided doses. Temporary relief of Otalgia in geniculate neuralgia may be achieved by applying a local anesthetic or cocaine to the trigger point, if in the external auditory canal.

2. Corticosteroids and oral acyclovir can be administered. Steroids in the form of prednisolone can be administered orally in doses of 10mg twice a day. Steroids should not be stopped abruptly. The dosage needs to be tapered. Acyclovir can be administered in doses of 800 mg orally 5 times a day.

3. Management of vertigo: can be managed using meclizine in doses of 25 mg orally 4 times a day.

4. Care must be taken to prevent exposure keratitis because of the inability to close the eye lids. The patients must wear protective goggles.