Ramsay-Hunt Syndrome

Nurses General Nursing


Hi, everyone!

Last Tuesday I had what I thought was an insect bite just inside my ear. On Wednesday paralysis started on the right side of my face. Thursday morning it was worse, so I went to the ER where the doc diagnosed Bell's Palsy or Ramsay-Hunt Syndrome. I was very fortunate to see a neurologist within hours, and he confirmed RHS. My treatment is Prednisone and acyclovir. I've searched every web site possible but couldn't find very much info. Can anyone give me any insight as to when I can expect to see recovery begin? It's been 3 days ( I know that's not long,) and there has been no improvement in facial function. My family is very supportive, but I'm beginning to get a little depressed. Good news or bad from you is okay. I just need some answers. Throw them at me...I can take it.

Thanks for your help,


Specializes in NICU, Informatics.

The onset of Bell's palsy is fairly abrupt, just as you have described, some sources [Harrisons textbook of medicine] state that maximal weakness is usually attained by 48 hours [as a general rule]. Pain behind the ear may precede the paralysis for a day or two. Taste sensation may be lost unilaterally, and hyperacusis may be present. In some cases there is mild cerebrospinal fluid (CSF) lymphocytosis. The good news is that approximately 80 % of patients recover within a few weeks or months. Evidence of denervation after 10 days indicates that there has been axonal degeneration and that there will be a long delay (about 3 months), before regeneration occurs and that it may be incomplete. The presence of incomplete paralysis in the first week is the most favorable prognostic sign.

The most important thing for you to do right now is to take your medication just as your primary care provider recommends, keep up good nutrition, rest, and keep your anxiety low. My best wishes for a speedy recovery.

JenKatt and Tim,

Thanks so much for the information. Although I haven't seen any improvement, I'm still hopeful. I'm not as tired as I was a couple of days ago, and my ear pain is gone. My husband insists that I stay in bed, but it's so hard! We "caregiver types" aren't the ones who can easily let others help.

Thanks again!


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