Early and appropriate treatment of Ramsay Hunt Syndrome is crucial for optimal outcomes. The most effective treatment combines antiviral medications with corticosteroids, ideally started within 72 hours of symptom onset.
0-24 Hours
Optimal treatment window - best outcomes
24-72 Hours
Still effective - good outcomes possible
3-7 Days
Limited benefit - may help with pain
After 7 Days
Supportive care and rehabilitation
Acyclovir
800mg 5x daily for 7-10 days
First-line treatment
Valacyclovir
1000mg 3x daily for 7 days
Better bioavailability
Famciclovir
500mg 3x daily for 7 days
Alternative option
Prednisolone
1mg/kg daily (max 80mg) for 5-7 days
Reduces inflammation
Methylprednisolone
1-2mg/kg daily, then taper
IV option for severe cases
Pain Management
Acute Pain
- • NSAIDs (ibuprofen, naproxen)
- • Acetaminophen
- • Topical analgesics
Neuropathic Pain
- • Gabapentin (300-900mg daily)
- • Pregabalin (150-300mg daily)
- • Tricyclic antidepressants
Eye Care
Protection
- • Artificial tears (frequent application)
- • Eye patches at night
- • Protective eyewear
Severe Cases
- • Taping eyelid closed
- • Moisture chambers
- • Ophthalmology referral
Physical Therapy
- • Facial muscle exercises
- • Massage therapy
- • Electrical stimulation
- • Range of motion exercises
- • Balance training (if vertigo present)
Speech Therapy
- • Articulation exercises
- • Lip and tongue strengthening
- • Swallowing assessment
- • Communication strategies
- • Facial expression training
Psychological Support
- • Counseling services
- • Support groups
- • Coping strategies
- • Body image counseling
- • Stress management
For Incomplete Recovery
Botulinum Toxin
For synkinesis and facial spasms
Facial Reanimation Surgery
Nerve grafts, muscle transfers
Eyelid Surgery
Gold weight implants, tarsorrhaphy
Hearing and Balance Issues
Hearing Aids
For sensorineural hearing loss
Vestibular Rehabilitation
Balance training and adaptation exercises
Cochlear Implants
For severe hearing loss (rare)
Recovery Rates
Factors Affecting Outcome
- Early treatment: Within 72 hours
- Age: Younger patients recover better
- Severity: Complete vs incomplete paralysis
- Comorbidities: Diabetes, immunosuppression
Emergency Situations
- • Severe eye pain or vision changes
- • Signs of corneal damage
- • Worsening neurological symptoms
- • Signs of secondary bacterial infection
Drug Interactions and Contraindications
- • Kidney function monitoring with antivirals
- • Steroid contraindications (diabetes, infections)
- • Drug interactions with immunosuppressants
- • Pregnancy and breastfeeding considerations
Medical Disclaimer: This treatment information is for educational purposes only and should not replace professional medical advice. Treatment decisions should always be made in consultation with qualified healthcare providers who can assess individual circumstances and medical history. Never start, stop, or change medications without medical supervision.