How Justin Bieber got connected to James Ramsay Hunt

Justin Bieber, the young musical sensation has been on a spree of cancelling all his shows and 'Beliebers' couldn't keep calm not knowing why.
Justin Bieber, the young musical sensation has been on a spree of cancelling all his shows (Wikimedia)
Justin Bieber, the young musical sensation has been on a spree of cancelling all his shows (Wikimedia)

Justin Bieber, the young musical sensation has been on a spree of cancelling all his shows and 'Beliebers' couldn't keep calm not knowing why until Bieber posted a video on Instagram captioned 'Important Please Watch'.

However, the video has spurred the curiosity of netizens even further. In the video, Bieber discloses that he is affected by Ramsay Hunt Syndrome, a rare condition. The right side of Bieber's face is expressionless and looks paralysed. Bieber goes on to say that he can't be back on stage for a while and that he needs to rest till his condition is resolved.

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What exactly is Ramsay Hunt Syndrome?

Named after the American neurologist James Ramsay Hunt, the syndrome is caused by the virus Varicella Zoster affecting the geniculate ganglion of the facial nerve. Known as RHS Type 2 or Herpes Zoster Oticus, the syndrome usually presents with a classic triad of facial paralysis involving one side of the face, pain in the ear and vesicles on the outer ear or auditory tube.

A classic triad of facial paralysis involving one side of the face, pain in the ear and vesicles on the outer ear or auditory tube is seen (Wikimedia)
A classic triad of facial paralysis involving one side of the face, pain in the ear and vesicles on the outer ear or auditory tube is seen (Wikimedia)By Worme M, Chada R, Lavallee L - http://openi.nlm.nih.gov/detailedresult.php?img=3847606_1756-0500-6-337-2&query=ramsay%20hunt&it=xg&lic=by&req=4&npos=3, CC BY 2.0, https://commons.wikimedia.org/w/index.php?curid=39675870

Why and How does this condition occur?

Sometimes even after chickenpox or shingles is cured, which are both caused by the Varicella zoster virus, the virus stays back in the affected person in a dormant state. The virus gets reactivated when the immune system becomes weak again due to an illness or some other reason. The reactivated virus then travels to the ends of nerve cells. If the nerve cells involved are part of the facial nerve, it results in Ramsay Hunt Syndrome.

The geniculate ganglion which is responsible for movements of facial muscles, sensations of the ear and auditory canal, taste in the anterior two-thirds of the tongue and moistening of eyes and mouth gets affected.

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What are the symptoms?

Common symptoms include:

  • reddish vesicular rash near the ear

  • inability to move one side of the face ie smile, close eyes

  • extreme pain in the ear, jaw or neck

  • loss of taste

  • slurry speech

  • dry mouth and eyes

If the infection spreads to the vestibulocochlear nerve, ringing in the ears (tinnitus), loss of hearing, hyperacusis (increased sensitivity to sounds) and vertigo are common. In rare cases, the hearing loss may be permanent.

Is RHS curable?

A combination of antivirals and corticosteroids is used to treat Ramsay Hunt Syndrome. Outcomes are best when treatment is initiated within 3 days of the infection and further delay may result in permanent damage. To relieve more acute symptoms specific medications and physical therapy is advised.

Zoster vaccine is recommended for adults 50 years and older who are most susceptible to the infection

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Is RHS the same as Bell's Palsy?

Though both may have a viral origin, Bell's palsy is more rapid in onset and less severe. Bell's palsy might resolve on its own whereas RHS may lead to permanent deafness. Rashes and vesicles are usually not associated with Bell's palsy. However, misdiagnosis of RHS as Bell's palsy may cause further complications.

Bieber stated that he is getting rest and doing facial exercises (Wikimedia)
Bieber stated that he is getting rest and doing facial exercises (Wikimedia)

As Bieber stated that he is getting rest and doing facial exercises, let's hope that he has a speedy recovery. Meanwhile, folks don't be worried that you may have the virus as it is a pretty rare disease and does not spread like covid-19. Nevertheless, be wary of red rashes and blisters near the ears or stiffness of jaws along with intense pain in the ears and meet a doctor as early as possible in case of doubt.

Hopefully, most of us won't make the rare connection that Justin Bieber made with James Hunt Ramsay.

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