Can Shingles Cause Facial Paralysis? Understanding Ramsay Hunt Syndrome
The disease, which occurs in many people, has recently become quite common. Although this disease seems innocent, it also causes situations such as facial paralysis in the later stages. At this point, "Can Shingles Cause Facial Paralysis? Understanding Ramsay Hunt Syndrome". You can have detailed information about the disease by reviewing the content. We wish you all healthy days and good reading.
What is Shingles?
Shingles, medically known as herpes zoster, is a painful infectious disease that occurs when the Varicella Zoster virus, which causes chickenpox, reactivates in the body after years, affecting the nerve roots and skin surface. The virus that causes this disease can remain inactive for many years in people who have had chickenpox. However, when the immune system is weakened - especially after stress, old age, chronic illness or immunosuppressive therapies - the virus can re-invigorate and travel along the nerve, causing a painful, red, fluid-filled rash on the area of skin that follows the line. This can cause severe pain, burning and stinging on one side of the body, often in the back, lower back, chest or face, and can eventually involve the optic or facial nerves, leading to more serious complications or even neurological problems such as facial paralysis (Ramsay Hunt Syndrome).
What Causes Shingles?
Shingles occurs when the Varicella Zoster virus, which causes chickenpox, reactivates in the body after many years. When a person has chickenpox in childhood or adolescence, the virus can lodge in nerve cells and remain silent there for a long time. However, aging, weakening of the immune system, severe stress, chronic illnesses, cancer treatments, HIV infection, etc. can lead to the virus being reactivated. Therefore, the activated virus moves along the nerve fibers towards the skin and manifests itself with symptoms such as redness, blisters, burning and stinging in that area. It is especially more common in people over the age of 50 and in immunocompromised individuals.
How Does Shingles Occur?
Chickenpox is a childhood disease caused by the introduction of this virus into the body. Once in the body, the virus usually lodges in the nerve roots in the skin, where it remains inactive. However, when the immune system weakens, the virus is reawakened by factors such as aging, stress, immunosuppressive treatments (e.g. cancer treatment or organ transplantation). The reactivated virus travels along the nerve and causes painful rashes on the skin following the nerve. As a result, the virus damages nerve cells as it travels through the body, causing redness, blisters, severe burning, stinging and pain. Therefore, shingles is a very painful process because it damages nerve cells in the body.
Symptoms of Shingles
As with any disease, shingles has its own symptoms. Although these symptoms sometimes appear in the early stages of the disease, sometimes they appear in the later stages of the disease. In this context, the symptoms of shingles are as follows;
Early Symptoms:
- Mild headache
- Weakness and fatigue
- Fever
- Muscle aches
- Skin sensitivity and itching
Pain and burning:
- Burning, stinging or pain along the nerve
- Severe pain, especially before rashes
- The pain is often concentrated on one side, in a specific area
Rashes:
- Redness and rashes on the skin
- Rashes in the form of water-filled blisters (vesicles)
- The rashes are usually unilateral and appear on a specific part of the body (such as the back, waist, chest, face).
Sensitivity:
- Hypersensitivity at the site of the rash
- Increased skin soreness or sensitivity to touch with rashes
Neurological Symptoms:
- Facial paralysis (Ramsay Hunt Syndrome)
- Hearing loss and tinnitus
- Taste disturbance
Eye Attention (especially in the face area):
- Pain in the eye
- Inflammation of the eye or loss of vision
- Watery or dry eyes
Postherpetic Neuralgia:
- Pain that lasts for months after the rash has healed
- Persistence of nerve pain and tenderness
Does Shingles Cause Facial Paralysis?
Yes, shingles can cause facial paralysis in some cases. If the virus spreads to areas affecting the facial nerve (facial nerve), this can lead to the development of facial paralysis. Therefore, a condition in which the facial nerve is involved and the shingles virus is localized to the areas around the ear and inner ear is known as Ramsay Hunt syndrome. This syndrome is a serious complication that can lead to facial paralysis.
When shingles causes facial paralysis, the earlier treatment is started, the better the chances of recovery. If not treated early, facial paralysis can become permanent and it can be difficult to fully repair the nerves, so the disease should be treated as early as possible. Otherwise, facial paralysis may become permanent.
The Relationship Between Shingles and Ramsay Hunt Syndrome
The relationship between shingles and Ramsay Hunt Syndrome is a different course of infection caused by the Varicella Zoster virus. In this case, shingles develops when the Varicella Zoster virus, which remains inactive in the body of people who have had chickenpox, is reactivated when the immune system is weakened or by triggering factors such as stress. The virus travels along the nerves and causes skin rashes. In some cases, however, the virus can affect the facial nerves (facial nerve) and the inner ear nerves. In this case, a condition called Ramsay Hunt Syndrome develops.
This syndrome is a serious condition that leads to facial paralysis and ear problems. The difference between shingles and Ramsay Hunt Syndrome is that it is accompanied by facial paralysis. When the facial nerve is affected, the patient's facial muscles weaken, the eyelid cannot close and painful facial muscles develop. Early diagnosis and treatment is very important to prevent these complications.
Can Shingles Trigger Bell's Palsy?
In some cases, shingles can trigger Bell's Palsy. This is because the Varicella Zoster virus remains latent (dormant) in the nerve roots of individuals who have had chickenpox and is reactivated when the immune system is weakened. The reactivated virus causes inflammation and edema, especially in the nerve fibers around the geniculate ganglion of the facial nerve. This inflammation causes an increase in pressure within the nerve bundles, damaging the myelin sheath and slowing down the nerve conduction velocity.
As a result, electrical signals to the facial muscles are blocked or weakened. This creates a clinical picture of Bell's Palsy, a sudden onset of facial paralysis. Therefore, the direct effect of the shingles virus on the nerve tissue and the neuritis it causes can trigger Bell's Palsy-like facial paralysis.
What are the Shingles Treatment Methods?
The aim of shingles treatment is to stop the virus from multiplying, control pain and reduce the risk of complications. Therefore, treatment of shingles usually involves the following steps;
- Drugs such as acyclovir, valacyclovir or famciclovir prevent the virus from multiplying in nerve cells. For best results, they should be started within the first 72 hours after the rash appears.
- Mild painkillers such as paracetamol or ibuprofen may be preferred; in case of severe pain, tramadol or opioids may be preferred. Corticosteroids (e.g. prednisone) can relieve pain by reducing nerve edema.
- Nerve pain medications such as gabapentin, pregabalin or low-dose amitriptyline are used to prevent or relieve postherpetic neuralgia.
- It is important to apply cold compresses, keep the skin clean and dry, reduce the risk of infection and soothe the blisters with dressings or lotions.
- In some cases, sudden bouts of pain can be controlled by nerve blockade or epidural steroid infusion.
- Especially if there is paralysis or restriction of movement in the facial area, physical therapy exercises support the restoration of muscle function.
- The shingles vaccine (recombinant zoster vaccine) significantly reduces the severity of the disease and the risk of postherpetic neuralgia in people over 50 who have previously had chickenpox.
And also when shingles turns into ramsay hunt syndrome;
- Gracilis Muscle Transplant (Dynamic Reconstruction with Masseter Nerve)
- Facelift for Facial Palsy (Static Sling/Facelift)
- Selective Neurolysis
- Selective Myectomies
- Eyelid Surgery for Facial Palsy
If you want to get rid of the facial paralysis you experience after shingles, you can contact Doctor Be's expert team immediately.
