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.
Time is Critical
The effectiveness of treatment decreases significantly after 72 hours. Seek immediate medical attention if you suspect Ramsay Hunt Syndrome.
Antiviral Medications
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
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)
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
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
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