Ramsay Hunt Syndrome

Common misdiagnosis for an uncommon outbreak of shingles in one ear. Signs, symptoms and treatment.

As a child I had an outbreak of Chickenpox and knew as an adult the Varicella virus would remain dormant in my body with the adult threat of reawakening into Herpes Zoster (Shingles.) I was over fifty years old remembering my doctor's advise to receive the Herpes Zoster vaccine, but no, procrastination took hold to push it off until the end of the year. My immune system wasn't compromised by illnesses nor drugs, yet the virus knew that my body was undergoing a long stretch of stress. The offender was the emotional wearing of a complicated divorce. When my immune defenses were vulnerable, the microscopic warrior attacked my ear canal and then crept into my inner ear along the nerves, destroying them as it went until it reached my seventh and eighth cranial nerves that control facial muscular motor movements, hearing and balance. The final diagnosis was Ramsay Hunt Syndrome based on the location of the outbreak. A rare condition until it happens to you!
The initial symptom was infrequent waves of vertigo lasting for two days. Then came an earache in one ear. I went to an urgent clinic. My red ear canal and vertigo was diagnosed as an ear infection. Doctor prescribed an antibiotic and Meclizine for the vertigo. On the third 4:00 a.m. day I woke up with the first thought, "Something is very wrong." I sat up in the darkness and ran my fingers on one side of my face. Half of my face was paralyzed from forehead to chin and a sliver of lack of taste along the side of my tongue. It was as if a vertical line was drawn halfway down my face magically freezing movement. Then I tried to pop out of bed and almost fell due to my balance was disrupted on the affected side. I staggered out of bed to the mirror and yelled an expletive that I was having a stroke, so I summoned an Uber driver destined for the emergency room. He arrived at my house in 6 minutes.
My contrast CAT scan ruled out stroke. An Ear, Nose and Throat doctor was called in and diagnosed herpes. Luckily, he ordered the same drugs used for Ramsay Hunt Syndrome which were an antiviral, intravenous prednisone and an antibiotic in case of a secondary bacterial infection. I was discharged in twenty-four hours with the same symptoms. I was dissatisfied with the diagnosis, so I made an appointment with an infectious disease doctor. The moment I finished telling him what happened while he was observing me was, he told me I have Ramsay Hunt Syndrome. He extended my use of an antiviral and prednisone and ordered me to see an ophthalmologist to protect my non-blinking eye. He ordered physical therapy too. He also let me know that I had started the antiviral medication within seventy-two hours of my initial symptoms so my chances to recover from the paralysis was at least seventy-five percent. He also informed me that the storm would begin shortly as he could see vesicles(blisters) in my ear canal. Well, he wasn't exaggerating. My ear canal swelled shut, the vertigo spun me into constant vomiting and my ear felt like a stabbing icepick producing a headache that beats a migraine. Finally I was given valium to stop the vertigo, yes, valium since the Meclizine did nothing. Once the war was over I started physical therapy. Let's put it this way it took four years to be able to ski again.
Prevention: read CDC.gov about the shingles vaccine. Remember the initial symptoms of waves of vertigo, then an earache. Get a second opinion if ear infection is diagnosed with those initial symptoms, even tell the doctor if you had Chickenpox as a child. Ask; could it be Ramsay Hunt Syndrome? Let him or her look it up if they have to because it's rare. Remember the faster you receive an antiviral and prednisone within seventy-two hours, the faster it can suppress the Herpes Zoster from doing further damage. Written and experienced by Veronica Cherry at gallantbooks.com