Medical Specialties

At the Center for Neurosciences, we work together across specialties to provide the best, most comprehensive approach to treatment.

Ramsay Hunt Syndrome

Ramsay Hunt Syndrome (RHS) is a rare disorder caused by the varicella zoster virus (the same virus that causes chickenpox and shingles). RHS is a shingles outbreak that occurs on the facial nerve, which is near the inner ear. The facial nerve becomes irritated and swollen, causing facial weakness or paralysis. Additionally, a red, painful rash with blisters is found in the ear canal, eardrum and sometimes the mouth. A poly-cranial-neuropathy may occur in some patients, thereby causing sensorineural hearing loss, balance dysfunction, abnormalities of facial sensation, vocal cord paralysis and even tongue weakness.

It is critical to receive a medical evaluation promptly if you experience any facial weakness or paralysis, as the risk of long-term complications associated with RHS is greatly reduced if treatment is received within a few days of symptoms appearing. RHS is diagnosed by medical history and examination of the face and ears. A sample of fluid from a blister may be drawn to culture the virus and confirm the diagnosis. Several medication options exist for treatment, including antivirals, corticosteroids (to reduce inflammation of the facial nerve), pain relievers, and anti-anxiety medications. Even with proper treatment, long-term outcomes are not as favorable as for those with Bell’s Palsy. Long-term facial weakness, hearing loss, chronic pain syndromes, and balance dysfunction may occur. Workup with an MRI scan of the Brain (with internal auditory canal protocol) is required to image the facial nerve from brainstem into the parotid gland.

Why Choose Us

  • Dr. Abraham Jacob, Medical Director for Ear & Hearing (E&H) at the Center for Neurosciences (CNS), is fellowship trained in Otology, Neurotology, and Cranial Base Surgery. He is the first and most experienced Neurotologist in Tucson.
  • Dr. Jacob was a founding member of the University of Arizona (UA) Department of Otolaryngology prior to his departure and transition to CNS. At UA, he was Vice Chair of ENT and held the rank of full Professor with Tenure. He has an international reputation as an expert for treating ear diseases.
  • Dr. Jacob transitioned his practice to the Center for Neurosciences in early 2017 as he felt that the new environment helped him to optimize delivery of personalized ear and lateral skull base care for his patients.
  • Dr. Jacob offers state-of-the-art medical and surgical care for patients with all types of ear and lateral skull base disorders. As a Neurotologist, he is uniquely qualified to detect, diagnose, evaluate, treat and rehabilitate all disorders of the facial nerve. If facial nerve surgery is required, he is one of very few ENT surgeons in the state of Arizona trained to do such operations.