Ramsay Hunt Syndrome: Justin Bieber’s diagnosis explained

Rare neurological condition is caused by the virus that is known to cause chickenpox

On June 10, international pop sensation Justin Bieber posted a video on Instagram announcing that he had been diagnosed with Ramsay Hunt Syndrome, which causes paralysis on one side of the face. He asked followers to keep him in their prayers.

Bieber had previously announced the cancellation of tour dates and explained how he was "physically, obviously not capable of doing them".

What is Ramsay Hunt Syndrome?

The syndrome is an extremely rare neurological condition caused by the varicella-zoster virus, the same virus that is known to cause chickenpox and shingles. The virus, even after recovery, may lay dormant in the body and be reactivated, causing irritation and inflammation of facial nerves. The syndrome is characterised by facial palsy (paralysis of facial nerves) and a rash affecting the ear or mouth.

"As you can see, this eye is not blinking," Bieber said in his video. "I can’t smile on this side of my face. This nostril will not move."

What are the symptoms?

According to the Mayo Clinic, the two prominent symptoms of Ramsay Hunt Syndrome are painful red rashes in and around the ear and paralysis or facial weakness on the same side as the affected ear. Sometimes, the rash may not occur. At other times, the rash and the paralysis may not occur simultaneously. One might also experience ear pain, loss of taste and smell, vertigo and tinnitus.

What is the cause?

It can happen to anyone who has ever had chickenpox. It typically affects older adults and cases in children are rare. While the syndrome isn't contagious, the activated virus can cause chickenpox in people who previously haven't been affected or vaccinated for it. According to the National Organisation for Rare Disorders (NORD), US, "The reason why the virus reactivates and affects the facial nerve in Ramsay Hunt syndrome is unknown."

What is the treatment?

According to NORD, antiviral drugs like acyclovir or famciclovir and corticosteroids like prednisone are routinely used to treat Ramsay Hunt. Most experts agree that starting antiviral treatment within three days of diagnosis looks to be the most beneficial as early diagnosis and management appear to enhance results. In certain situations, facial paralysis and hearing loss may become permanent despite treatment.

How can Ramsay Hunt be prevented?

Chickenpox vaccination is now routinely administered to children, considerably reducing the risk of infection with the virus. A shingles vaccine is also advised for people over the age of 50.

"We don’t know how much time it's gonna be but it's gonna be okay, I hope," said Bieber in the video.