Ramsay Hunt Syndrome, the Condition that Justin Bieber Has

In a video shared on his social media, Justin Bieber reported that he suffers from Ramsay Hunt syndrome. Let's see what it is and what its characteristics are.

Reviewed and approved by the pediatrician Marcela Alejandra Caffulli.

Written by Johan Benitez

Last update: 27 December, 2022

On Friday, June 10, 2022, Justin Bieber announced the cancellation of the upcoming concerts that are part of his world tour. In the video posted on his Instagram account, the star stated that he suffers from Ramsay Hunt syndrome, a rare disease that has left half of his face paralyzed.

In the publication, Bieber refers to his current condition with the following words: “As you can see, this eye is not blinking. I can’t smile on this side of my face. This nostril will not move.” His statements aroused the interest of millions of people around the world, and not just his followers. That’s why today, we’re going to show you what the syndrome afflicting the artist is all about.

What is Ramsay Hunt syndrome?

Ramsay Hunt syndrome, also known as herpes zoster oticus or geniculate ganglion herpes zoster, is a complication of varicella-zoster virus (VZV) infection. It’s named after James Ramsay Hunt (1872-1937), the neurologist who described the clinical picture following his research.

This health condition is characterized by unilateral facial paralysis, which is accompanied by ear pain and vesicles in the ear canal on the same side. It affects both people with a competent immune system and those with a deficiency, and an estimated 22.6 out of every 10,000 people worldwide suffer from it.

As anticipated, it’s a complication of VZV infection and occurs, in the long term, as a reactivation of the virus that remains latent within the body. For this reason, most cases occur in adulthood and in particular, after the age of 50. However, experts indicate that up to 10% of cases of facial paralysis in children are due to this cause.

Causes of Ramsay Hunt syndrome

The clinical condition we’re talking about is a late consequence of VZV infection. In general, this virus enters the human body during childhood and causes the typical chickenpox. Once it’s resolved, this infectious agent remains latent in the body of some neurons, and under certain circumstances that reduce defenses (such as stress), it can reactivate in the form of herpes zoster.

It should be noted that although the virus can be transmitted, this doesn’t imply that the recipient will develop this disease. In fact, a person who hasn’t developed antibodies to VZV in the past is likely to develop chickenpox upon first contact with the virus.

For this reason, if any of the clinical manifestations of VZV infection are present, contact with the following groups of people should be avoided:

• Newborns
• Children who haven’t had chickenpox or who aren’t vaccinated
• People with compromised or deficient immune systems
• Pregnant women who haven’t developed antibodies to VZV

Symptoms of Ramsay Hunt syndrome

The clinical manifestations of Ramsay Hunt syndrome vary from case to case, but in most a facial nerve palsy and a vesicular rash near the ear develop. These two symptoms can appear together or in continuation and their intensity is variable. Characteristically, however, only one side of the face is affected.

In paralysis, the facial muscles may feel stiff or weak and don’t contract when the person tries to wrinkle the forehead, smile, or close the eye on the affected side. This is something we have seen in the video that Justin Bieber shared on his Instagram account.

At the same time, on the same side of the paralysis, it’s common for a red rash with vesicles to appear, which is painful to the touch near the pinna. Even, inside the outer ear. In some people, these lesions are also seen in the mouth, soft palate, and fauces.

Other symptoms that may accompany Ramsay Hunt syndrome include the following:

• Ringing in the ears
• Dizziness
• Dry mouth and eyes
• Loss of taste
• Ear pain
• Nausea and vomiting

The prognosis of the disease

Researchers point out that the facial paralysis of Ramsay Hunt syndrome has a worse prognosis than that observed in Bell’s palsy (a condition that causes similar signs). On average, only 70% recover normal or near-normal facial function, compared to more than 90% of cases with Bell’s palsy. Similarly, some sequelae, such as synkinesia (involuntary muscle movement) and neuritis (swelling of the optic nerve) are more severe in this syndrome than in Bell’s palsy. However, the intensity of the symptoms and their evolution are very uneven among patients. In any case, there are several treatment alternatives for dealing with the syndrome in question.

Treatment options for Ramsay Hunt syndrome

As noted by the National Organization for Rare Disorders (NORD), therapy for Ramsay Hunt syndrome involves antiviral drugs. Drugs such as acyclovir (Zovirax), famciclovir (Famvir), or valacyclovir (Valtrex) are the most commonly used in these cases, and the earlier they’re started, the greater the likelihood of reducing sequelae. Other medications that may be used include corticosteroids, anti-anxiety medications, and pain relievers.

Additional treatments are chosen based on the symptoms that afflict the individual. For example, artificial tears, ointments, and anti-vertiginous medications may be considered.

About Ramsay Hunt syndrome

In summary, Ramsay Hunt syndrome is a rare consequence of infection with the virus that causes chickenpox. Its prognosis varies from person to person and even with proper and timely treatment, some of its symptoms persist. In general terms, this is the syndrome that has prevented Justin Bieber from completing his international tour.