The patient is trying to close both eyes. Ramsay Hunt syndrome

Ramsay Hunt syndrome (RHS) is a name given to herpes zoster infection which involves the ear (AKA herpes zoster oticus). In addition to vesiculation of the ear, patients develop some form of impairment of cranial nerve 7 (facial hemiplegia, partial loss of taste) or 8 (decreased hearing, tinnitus, and nystagmus). The viral infection involves the geniculate ganglion. Vesiculation of the tympanic membrane and adjacent skin may occur as well as nausea and vomiting. See also herpes zoster.


Therapy should involve consultation with a neurologist. See herpes zoster. Oral antiviral therapy, e.g., acyclovir within 72 hours of rash onset, leads to the best outcomes in most adults. Prednisone is sometimes given as well. Unfortunately, less than 50% of patients achieve complete neurologic recovery.

Additional Pictures

Same as patient above.
Ramsay Hunt syndrome


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