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Ramsay Hunt Syndrome Treatment & Management

  • Author: Augusto A Miravalle, MD; Chief Editor: Niranjan N Singh, MD, DM  more...
Updated: Oct 06, 2015

Medical Care

Corticosteroids and oral acyclovir are commonly used in the treatment of Ramsay Hunt syndrome. In one review, combined therapy using corticosteroids plus intravenous acyclovir did not show benefit over corticosteroids alone in promoting facial nerve recovery after 6 months. However, randomized clinical trials evaluating both therapies are required.[9]

Another study concluded that controlled-release oxycodone was safe and generally well tolerated in patients experiencing acute pain due to herpes zoster.[10]

Vestibular suppressants may be helpful if vestibular symptoms are severe.

As with Bell palsy, care must be taken to prevent corneal irritation and injury.

Temporary relief of otalgia may be achieved by applying a local anesthetic or cocaine to the trigger point, if in the external auditory canal.

Carbamazepine may be helpful, especially in cases of idiopathic geniculate neuralgia.



Consultation with an infectious disease specialist is recommended.

If a structural lesion is discovered on imaging, consultation with a neurosurgeon or otolaryngologist is recommended.

Consultation with an ophthalmologist to assist with eye care, especially pertaining to the cornea, may be appropriate.

Contributor Information and Disclosures

Augusto A Miravalle, MD Fellow, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School

Augusto A Miravalle, MD is a member of the following medical societies: American Academy of Neurology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Florian P Thomas, MD, PhD, Drmed, MA, MS Director, National MS Society Multiple Sclerosis Center; Professor and Director, Clinical Research Unit, Department of Neurology, Adjunct Professor of Physical Therapy, Associate Professor, Institute for Molecular Virology, St Louis University School of Medicine; Editor-in-Chief, Journal of Spinal Cord Medicine

Florian P Thomas, MD, PhD, Drmed, MA, MS is a member of the following medical societies: Academy of Spinal Cord Injury Professionals, American Academy of Neurology, American Neurological Association, Consortium of Multiple Sclerosis Centers, National Multiple Sclerosis Society, Sigma Xi

Disclosure: Nothing to disclose.

Chief Editor

Niranjan N Singh, MD, DM Associate Professor of Neurology, University of Missouri-Columbia School of Medicine

Niranjan N Singh, MD, DM is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, American Headache Society

Disclosure: Nothing to disclose.


Deepak Awasthi, MD Clinical Professor, Department of Neurosurgery, Louisiana State University School of Medicine; Consulting Staff, Louisiana Brain and Spine Clinic

Deepak Awasthi is a member of the following medical societies: Alpha Omega Alpha and Phi Beta Kappa

Disclosure: Nothing to disclose.

Augusto A Miravalle, MD Fellow, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School

Augusto A Miravalle, MD is a member of the following medical societies: American Academy of Neurology

Disclosure: Nothing to disclose.

Marion Priscilla Short, MD Assistant Professor, Departments of Neurology, Pediatrics, and Pathology, University of Chicago Hospitals and Clinics

Marion Priscilla Short, MD is a member of the following medical societies: American Academy of Neurology, American Association of Neuropathologists, American College of Medical Genetics, American Medical Association, and American Society of Human Genetics

Disclosure: Nothing to disclose.

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Herpes zoster oticus, day 6. Image courtesy of Manolette Roque, MD, ROQUE Eye Clinic.
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