Ramsey Hunt Syndrome

Dr. Aaron Hartman

July 6, 2022


You may have heard about Ramsey Hunt Syndrome in the news lately. I’ve had some questions about it recently, so I thought I’d talk a little about what Ramsey Hunt syndrome is, what causes it, and some possible treatment options. While Ramsey Hunt is quite rare, similar syndromes that cause nerve damage are actually fairly common.

What is Ramsey Hunt Syndrome?

Ramsey Hunt Syndrome is one of many infection-induced nerve damage syndromes that we know about. It is typically caused by a reoccurrence of the varicella-zoster virus (VZV), also known as the chickenpox virus. So, in a way Ramsay Hunt is actually a type of limited shingles, typically seen with a lesion in the ear, which is close to one of the facial nerves. In this infection, the facial nerve is involved and this can cause significant pain as well as loss of muscle function.


What causes Ramsey Hunt?

While 80% of Americans have the chickenpox virus, after the first infection, it typically lays dormant in the body. However, the virus can be reactivated when the immune system is suppressed by things like stress, nutrient deficiencies, cancers, chemotherapy, or aging. When the virus reactivates, it typically presents as shingles, and may also cause Ramsey Hunt syndrome. Shingles can happen on different nerves in your body. So it could be on your chest, your back, or your arms, for example. There is a particular kind of shingles that causes lesions on the tip of the nose and can spread to a nerve that affects the eye and can cause blindness. When someone has a lesion on their nose, it’s important for them to get a specialized eye exam.
The cause of Ramsey Hunt is similar to that of other infection-induced nerve damaged syndromes. For example, Bell’s palsy, a kind of facial nerve damage, can be caused by a herpes virus called HSV and also can be caused by Lyme disease. There are also other viruses that can cause neuropathy or nerve damage, for example the Epstein Barr Virus (EBV), mononucleosis, and the herpes viruses.
While Ramsey Hunt, specifically, is quite rare, since there are many other similar syndromes, infection-induced nerve damage is unfortunately quite common.

What Kinds of Treatments are Available?

When someone experiences one of these nerve-damage syndromes, the acute viral infection must be treated first. Typically, this is done with antivirals and perhaps steroids if it’s severe. After the acute phase, if there is nerve damage, then on the nutritional side we can intervene to support healing of the nerves. Nutritional interventions might include things like B vitamins, alpha-lipoic acid (ALA), and N-acetyl cysteine (NAC). If the person has a fatty acid deficiency, using omega 3s can be very beneficial.
There are topical treatments that can also be effective. One of my favorite repurposed medications is naltrexone, also known as low-dose naltrexone. This can not only help with the pain from nerve damage, but also helps modulate the immune system. There are topical compounded medications, like ketotifen, compounded topical gabapentin, and compounded topical ketamine, which can also be very effective for nerve-damage syndromes.
There are other various treatments that can be effective for this type of nerve damage. Electrical stimulation and pulsed electromagnetic field therapy can help retrain the nerves and reduce the pain. Like many things in medicine, there are treatments out there, and the key is just finding a practitioner who can apply them.

A Key Question

The question you’re probably asking is:
Why do most people get these infections yet not experience severe neurological damage?
The answer lies within your immune system, and this is where functional medicine shines.
People who experience this kind of neurological damage typically have other immune issues, nutrient deficiencies, vitamin D deficiencies, and other factors. In young people with these issues I look for things like hyper-mobility and sleep apnea. These young people might be tall and slender. They may be athletic and perhaps are good runners. But the hyper-mobility also affects their immune system and makes them more prone to low-grade infections and nutriental deficiencies.
In contrast to our current disease-based model of medicine, functional medicine takes a deeper dive to find the connecting points and the other therapies that are available and effective. We look at the whole person in creating a treatment plan for optimal outcomes.
If you feel like this information has been helpful, please leave us a comment on Facebook or Instagram to let us know. We’d love to hear from you on social media!
Take care and be well.
Since 2010, Richmond Integrative and Functional Medicine has been helping people to restore their health and hope with an integrative approach to conventional and alternative medicine that’s entirely science-backed. We at RIFM believe everyone is made for health. We offer a comprehensive, in-person patient membership program to ensure you get access to the care you need to thrive.


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