Hearing loss is usually temporary and occurs in as many as 50% of patients. Some affected individuals develop sensorineural hearing loss, a condition in which sound vibrations are not properly transmitted to the brain due to a defect of the inner ear or the auditory nerve, resulting in hearing loss on the symptomatic side of the body (ipsilateral). In some patients, ear pain may be intense. Additional symptoms affecting the ear include ringing in the ear (tinnitus) and ear pain (otalgia). The rash, including painful blisters, may also affect the eardrum, mouth, soft palate and top portion of the throat, notably on the side with the affected nerve. Vesicular rashes of the ear and mouth have been reported in as many as 80% of patients. Most patients with Ramsay Hunt syndrome have a reddish (erythematous), painful, fluid-filled blistering (vesicular) rash that affects the outer portion of the ear (pinna) and often the external ear canal.
In rare cases, the clear, front part of the eye (cornea) can become damaged and blur vision. Asymmetric muscle tone may be visible and some people may have a drooping mouth and drool saliva.The inability to close the eye usually occurs and results in irritation. After the onset of symptoms, facial weakness is usually most severe within one week. In most people, only one side of the face is affected.įacial muscles affected by nerve palsy may be weak or feel stiff and result in the inability to smile or wrinkle the forehead, creating the appearance of a “saggy face”.
These two symptoms do not always occur at the same time. Affected individuals usually experience paralysis of the facial nerve and a rash affecting the ear. The symptoms of Ramsay Hunt syndrome vary from person to person.
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