Justin Bieber recently made headlines when cancelled his Justice World Tour. The reason is his illness. The Baby hitmaker has been diagnosed with Ramsay Hunt Syndrome. In a video posted on Instagram, Bieber said the condition has paralysed the right side of his face. “As you can see, this eye is not blinking. I can’t smile on this side of my face… So there’s full paralysis on this side of my face,” he said.
For the unversed, Ramsay Hunt Syndrome is a rare neurological disorder that causes partial facial paralysis. It can also lead to oral or ear rash and causes severe pain along the facial nerve of the affected part of the face.
The causes
The virus that causes chickenpox, the zoster virus, is the leading cause of the disorder. After suffering from chicken pox in childhood, the virus stays latent in the body and emerges when the immune system is depressed. Whenever the body is under severe stress, it may trigger the virus. It could even occur due to health problems like diabetes or the body being in an immunocompromised state.
The symptoms
While most patients may experience facial paralysis and rash, the symptoms may vary from person to person.
Unable to smile
Not able to close eye on the affected side
Severe pain in the outer part of the ear
The ear pain may spread to the neck
Ringing in the ear
Hearing loss, in the affected ear
Hearing deficit
A painful red rash with fluid-filled blisters, inside the ear and around it
Vertigo — spinning or causing imbalance
Confusion
Drowsiness
Headaches
Change in taste
The diagnosis
Multiple tests will have to be undertaken to make sure that the person is infected with the virus. It includes:
Medical history, to check if the person was infected with chicken pox in the past
Physical examination
Nerve conduction test
Tissue or fluid samples will be taken of the affected area to confirm the diagnosis
The treatment
It can be treated with antivirals, steroids, physiotherapy, and medicines that help in reducing neurological pain. If not treated in time, a person may suffer from permanent facial weakness, disfigurement, and sometimes hearing loss. Also, since the eyelids at times do not close, this might damage the cornea, leading to blurred vision. Hence, the use of lubricants can help protect the eye. Healing of the virus takes about six weeks to three months.
Prevention
The virus is not contagious and the infected person cannot pass it on to another. The only known prevention is to be vaccinated against chickenpox as that will reduce the chances of getting infected with the virus. Zoster vaccines given to elderly and immunocompromised individuals reduce the chance of getting shingles.
(Dr Anita Mathew is an Infectious Disease Specialist, Fortis Hospital, Mulund and Dr Pawan Ojha is a Senior Consultant-Neurology, Fortis Hospital, Vashi)
