What is Ramsay Hunt syndrome, which is affecting Justin Bieber? 5 things to know

Justin Bieber had to postpone concerts this week after revealing he had Ramsay Hunt syndrome, a rare disease caused by a virus that left one side of his face paralyzed. The “Peaches” singer said that he is unable to blink, smile or move his nostril on the right side of his face.

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“As you can probably see from my face, I have this syndrome called Ramsay Hunt syndrome,” Bieber, 28, told his fans in an Instagram post on Friday. “It is from this virus that attacks the nerve in my ear and my facial nerves and has caused my face to have paralysis.”

Here are five things to know about Ramsay Hunt syndrome.

What is Ramsay Hunt syndrome?

According to the Mayo Clinic, Ramsay Hunt syndrome, also known as herpes zoster oticus, occurs when a shingles outbreak affects the facial nerve close to the ear. It is the same virus that can cause chickenpox and can occur in people who previously were infected with chickenpox, according to The Washington Post.

The National Organization for Rare Disorders said the disease is rare, affecting about 5 in 100,000 people in the U.S., according to one estimate. Older adults are more likely to be affected.

“The nerves that go through your face go through pretty narrow, bony canals, and when they’re inflamed they swell and lose the ability to function,” Dr. Anna Wald, an infectious disease specialist at the University of Washington School of Medicine, told The New York Times.

>> Justin Bieber reveals that he has partial facial paralysis

If the dormant varicella-zoster virus is reactivated, leading to shingles, it can affect the facial nerve and may lead to facial paralysis and hearing loss. Why the virus reactivates is unknown, CNN reported.

The disorder is the second most common cause of atraumatic peripheral facial paralysis, NORD said.

“It can happen to anyone,” Dr. Waleed Javaid, director of infection prevention and control at Mount Sinai Downtown in New York City, told the Times. “But it’s not something that people should be afraid of.”

What are the symptoms?

According to the Mayo Clinic, the two main signs of Ramsay Hunt syndrome are a painful red rash with fluid-filled blisters on, in and around one ear or facial weakness or paralysis on the same side. Blisters on the roof of the mouth can also occur.

The two symptoms do not always occur at the same time, CNN reported.

Affected individuals usually experience paralysis (palsy) of the facial nerve and a rash affecting the ear. In most cases, only one side of the face is affected (unilateral).

Individuals can also experience vertigo, a sensation of things spinning, according to the Icahn School of Medicine at Mount Sinai in New York City.

“You can see this eye is not blinking,” Bieber said in a YouTube video explaining his condition. “I can’t smile on this side of my face. This nostril will not move.”

Diagnosis and treatment

Treatment for Ramsay Hunt syndrome normally involves taking antiviral medication and patients normally make a full recovery.

According to Dr. Michael Ison, a professor of infectious diseases at Northwestern Feinberg School of Medicine, how long a person is affected by the disease can vary.

“Some people, it takes weeks. Some people, it takes months,” Ison told the Times.

He added that in rare cases, facial paralysis or hearing loss can be permanent.

Once the syndrome is diagnosed, anti-viral medication and steroids are recommended, according to the Post. That includes prednisone to reduce inflammation, and antiviral medicine such as acyclovir or valacyclovir may be prescribed, CNN reported.

Providing an accurate diagnosis for Ramsay Hunt syndrome can take a long time, researchers said. The virus can have symptoms similar to Bell’s palsy, which can also induce facial paralysis, the Times reported.

Can Ramsay Hunt syndrome be severe?

According to Facial Palsy UK, a charity in the United Kingdom, prompt treatment can make a significant difference to a patient’s outcome. Approximately 70% of patients who receive antiviral medication within three days of developing symptoms can make a full recovery, the Post reported. Most people make a full recovery if treatment begins within three days, according to Mount Sinai.

If treatment is delayed for more than three days, there is less of a chance of complete recovery, according to Mount Sinai. Children are more likely to experience a complete recovery than adults.

Who is Ramsay Hunt syndrome named for?

The disease is named for neurologist James Ramsay Hunt, who first described the illness, the Times reported.

According to the National Library of Medicine, Hunt was a pre-eminent 20th-century American neurologist. He was born in 1874 and died on July 22, 1937, at his summer home in Katonah, New York, according to The Associated Press. He was a native of Philadelphia and served as a neurologist at Columbia University in New York City.

Hunt was director of the New York Neurological Institute, consulting neurologist at the Psychiatric Institute and the Eye and Ear Hospital and the consulting psychiatrist at Lying-In Hospital.

He was a lecturer in the neurological department at Cornell University from 1900 to 1910, according to The Ithaca Journal. During World War I, he was a consultant in neuro-psychiatry with U.S. forces in France.

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