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Herpes zoster of the ear - Herpes zoster oticus - Ramsay-Hunt syndrome

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Painful rash on the ear that occurs when the varicella zoster virus infects the facial nerve near the inner ear. It usually affects people over the age of 60.

It causes severe pain in the ear, blistering of the ear and mouth, and facial paralysis on the same side. A clinical picture with associated dizziness is common.

Diagnosis is based on clinical history and physical examination.

Treatment is aimed at relieving the associated severe pain with analgesics and anti-inflammatory drugs. If treatment is started within the first three days of symptom onset, recovery time and sequelae are reduced. The usefulness of antiviral drugs in this condition is uncertain.

Bibliographic references
  1. Mary A Albrecht. Clinical manifestations of varicella-zoster virus infection: Herpes zoster. UpToDate. Aug 02, 2016.
  2. Adour KK. Otological complications of herpes zoster. Ann Neurol 1994; 35 Suppl:S62.
  3. Uscategui T, Dorée C, Chamberlain IJ, Burton MJ. Antiviral therapy for Ramsay Hunt syndrome (herpes zoster oticus with facial palsy) in adults. Cochrane Database Syst Rev 2008; :CD006851.
  4. Whitley RJ. infecciones por el virus varicela-zóster. Harrison. Principios de Medicina Interna. Volumen 2. 19º Edición: 1185
  5. Tolosa E. Enfermedades de los pares craneales. Séptimo par: nervio facial. Farreras Rozman. Medicina Interna. Volumen 2. 12º edición: 1503.
Author
Dr. Sara Vitoria
Copyright
© TeckelMedical 2026

Symptoms

    Blisters after pain in the ear

    Ear pain

    Blisters on outer ear

    Rash made up of painful blisters

    Swollen lymph node in the anterior part of the ear

Symptoms to watch out for

Fever (temperature higher than 38 ºC)
Hearing loss
Pain that doesn't subside with analgesics

Self-care

Consume over-the-counter pain relievers or anti-inflammatories.
Maintain a balanced diet: increase fruit, vegetable, and white meat consumption and reduce the intake of fatty meals and fritters.
Relative rest, rest until symptoms subside.
Check with your general practitioner about the prescription for antiviral treatment.
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