Treatment of Ramsay Hunt Syndrome

Effective treatment of Ramsay Hunt Syndrome requires prompt medical intervention, ideally within 72 hours of symptom onset. This comprehensive guide covers all aspects of treatment from acute management to long-term rehabilitation.

Critical Treatment Timeline

Time is Critical

The effectiveness of treatment decreases significantly after 72 hours. Seek immediate medical attention if you suspect Ramsay Hunt Syndrome.

0-24h
Optimal window
Critical
24-72h
Still effective
Important
3-7d
Limited benefit
Marginal
7d+
Supportive only
Late
Primary Medical Treatment

Antiviral Medications

Must start within 72 hours

Acyclovir (First-line)

Dosage: 800mg five times daily

Duration: 7-10 days

Most commonly prescribed, well-established efficacy

Valacyclovir (Alternative)

Dosage: 1000mg three times daily

Duration: 7 days

Better absorption, more convenient dosing

Famciclovir (Alternative)

Dosage: 500mg three times daily

Duration: 7 days

Good alternative if others not tolerated

Corticosteroids

Reduces inflammation

Prednisolone (Standard)

Dosage: 1mg/kg daily (max 80mg)

Duration: 5-7 days, then taper

Oral administration, widely available

Methylprednisolone (Severe cases)

Dosage: 1-2mg/kg daily IV

Duration: 3-5 days, then oral taper

For hospitalized patients or severe cases

Note: Monitor for contraindications (diabetes, active infections, peptic ulcers)

Supportive Care and Symptom Management

Pain Management

Acute Pain

  • • Ibuprofen 400-600mg TID
  • • Acetaminophen 1000mg QID
  • • Topical lidocaine

Neuropathic Pain

  • • Gabapentin 300-900mg daily
  • • Pregabalin 150-300mg daily
  • • Amitriptyline 25-75mg nightly

Eye Protection

Daily Care

  • • Artificial tears every 2 hours
  • • Protective eyewear outdoors
  • • Avoid dry environments

Night Protection

  • • Eye patches or tape
  • • Moisture chambers
  • • Lubricating ointments

Other Symptoms

Vertigo/Dizziness

  • • Meclizine 25mg TID
  • • Vestibular exercises
  • • Balance training

Dry Mouth

  • • Frequent water sips
  • • Sugar-free gum
  • • Saliva substitutes
Rehabilitation and Recovery

Physical Therapy

Facial Exercises

  • • Gentle facial massage
  • • Mirror exercises
  • • Resistance training
  • • Coordination exercises

Electrical Stimulation

  • • Neuromuscular stimulation
  • • TENS therapy
  • • Biofeedback training

Speech and Swallowing

Speech Therapy

  • • Articulation exercises
  • • Lip strengthening
  • • Communication strategies

Swallowing Assessment

  • • Dysphagia evaluation
  • • Safe swallowing techniques
  • • Dietary modifications
Treatment Monitoring and Follow-up

Regular Assessments

Week 1-2

Daily assessment of symptoms, medication tolerance

Month 1-3

Weekly evaluation of facial function recovery

Month 3-12

Monthly assessment, rehabilitation progress

Warning Signs

Seek Immediate Care If:

  • • Severe eye pain or vision changes
  • • Signs of corneal damage
  • • Worsening neurological symptoms
  • • Signs of secondary infection
  • • Severe medication side effects