Dear Dr. K: My aunt has Ramsay Hunt syndrome and her doctor said it was a second bout of chicken pox. Is that true?
The answer to your question is yes and no. In the strictest sense the answer is no, because your aunt doesn’t have generalized chicken pox, but rather a very localized rash. The answer is yes because, in general terms, Ramsay Hunt is a special form of shingles which is a reactivation of the dormant chicken pox virus (Varicella zoster).
Shingles gets its name because the Varicella virus breaks out in the distribution or dermatone of a single nerve affecting a localized “shingle” of our skin covering.
Ramsay Hunt is an interesting condition because it has unusual neurologic symptoms, in addition to the typical blistering rash. Typically, the patient’s first symptom is severe unilateral ear pain (before any rash). Other common symptoms include facial weakness or paralysis on the side of the ear pain, and ear problems including tinnitus, hearing loss and vertigo.
The shingles rash appears on the ear pinna, the side of the face and side of the neck under the ear.
This condition is preventable with the Zostavax (shingles) vaccine, and can be treated with an oral antiviral and corticosteroids. The earlier this therapy is started, the better.
So, thanks for your question as it may lead to greater awareness of this very unpleasant condition – and to more early diagnoses.