The varicella-zoster virus is the cause of Ramsay Hunt syndrome II. It can lie dormant in the body for decades after its first incarnation as chickenpox during childhood. As an adult a recurrance of the virus is shingles and a complication of shingles is Ramsay Hunt syndrome.

The varicella-zoster virus infection may lead to inflammation or damage to the seventh cranial nerve (facial nerve carrying about 7,000 'fibres' which control the facial muscles) over a number of days. An inflammatory response can be the onset of paralysis of one side of the subject's face. Although initial symptoms seem to be quite dramatic many patients may experience a full and complete recovery.

The Seventh Cranial Nerve or Facial nerve

A major part of Ramsay Hunt syndrome is Bell's palsy, the paralysing effect to one side of the face. There are a number of ways that Bell's palsy can be triggered and the onset of most cases is extremely quick. It isn't uncommon for a person to go to bed without any symptoms only to wake up the next day with partial facial paralysis. It is important to point out that Bell's cases only affect one side of the head due to damage caused to the seventh cranial nerve and if it is observed that other body parts are paralysed or both sides of the face are affected then other possibilities like brain trauma must be considered.

Although Ramsay Hunt Syndrome may cause Bell's palsy, the inverse does not occur i.e. Bell's palsy does not cause Ramsay Hunt Syndrome.

Bell's palsy can be brought on by:

• herpes simplex virus type 1
• mumps
• varicella-zoster virus
• influenza
• mononucleosis
• HIV
• Lyme disease
• typhoid fever
• tuberculosis
• tumour causing never compression
• skull facture
• diabetes
• Guillain-Barre syndrome
• multiple sclerosis
• myasthenia gravis