Fast Five Quiz: Bell Palsy and Other Facial Paralysis

Helmi L. Lutsep, MD


February 27, 2020

Oral corticosteroids and oral acyclovir are commonly used in the treatment of Ramsay Hunt syndrome. A review of 882 patients found that a combination of steroids and acyclovir was superior to treatment with steroids used as monotherapy. Starting treatment in the first week is correlated with the highest rate of improvement, although treatment started later still has some benefit.

Long-term antiviral prophylaxis is not routinely used in patients with Ramsay Hunt syndrome, although it should be considered in cases of recurrent herpes zoster or when cell-mediated immunity is known to be impaired. 

Intravenous high-dose methylprednisolone is not commonly used in the treatment of Ramsay Hunt syndrome; however, it may be considered as a treatment option in patients who do not respond well to standard antiviral and oral steroid therapy and exhibit clinical features that suggest a poor prognosis.

Ramsay Hunt syndrome is a self-limited disease and is not associated with mortality. However, it is associated with significant morbidity. Among patients with complete facial palsy, recovery rates as low as 10% have been reported.

Read more about the treatment of Ramsay Hunt syndrome.


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