- Justin Bieber announced he has a neurological condition that has left his face partially paralyzed.
- The condition called Ramsay Hunt syndrome is related to exposure to the virus that causes chickenpox.
- Steroids and some antivirals can be used to treat this syndrome.
Justin Bieber has been recently diagnosed with a rare neurological condition called Ramsay Hunt syndrome.
The entertainer posted to Instagram about his condition.
“As you can probably see from my face, I have this syndrome called Ramsay Hunt syndrome,” he told fans. “And it is from this virus that attacks the nerve in my ear and my facial nerves and has caused my face to have paralysis.”
Explaining why he’s canceling some appearances, he said one of his eyes can no longer blink, and he has “full paralysis” on that side of his face.
Rare condition caused by a common virus
Ramsay Hunt is related to the varicella-zoster virus, which causes chickenpox.
“In Ramsay-Hunt, the chicken pox virus reactivates and invades the nerve that supplies the muscles of expression of the face, known as facial palsy,” Derek Chong, MD, the vice-chair of neurology at Lenox Hill Hospital, told Healthline.
In some people, the virus can reactivate years later to cause a very familiar (and painful) condition called shingles. But in rare instances, it can cause a type of facial paralysis similar to Bell’s palsy.
“The virus had been dormant (sleeping) but awakens and starts multiplying within the nerve, usually when the immune system is weakened,” he explained.
Chong said reactivation of the chickenpox virus can bring a small or large outbreak of “weepy-looking” blisters on the face, eye, ear, or ear canal.
“This rash typically occurs but may be very mild,” he said. “The rash is the main thing that separates this from the standard ‘Bell’s Palsy,’ which is facial palsy without a rash.”
Chong warned that Ramsay Hunt might also affect the vestibulocochlear nerve that is responsible for our hearing and balance.
There is a vaccine for the varicella-zoster virus that causes chickenpox, but it was not widely available until the mid-1990s.
Symptoms can be severe
Chong explained that the virus causes injury to the facial nerve, which supplies muscles of the forehead, eye closure, lip closure, and smiling muscles, making them weak.
“There are other muscles that are NOT affected by Ramsay-Hunt, including the muscles for chewing, swallowing, and controlling tongue,” he continued. “But people may have trouble eating because the lips will become weak and not be able to hold liquids and food in the mouth well.”
Chong said there are also smaller nerves that “piggyback” on the facial nerve, which activate the salivary gland and the tear ducts.
“These are often injured as well,” he said.
Lipps said that symptoms of Ramsay Hunt syndrome might include a painful rash on the ear, tongue, or mouth (usually one-sided), facial paralysis, hearing loss/ringing in the ear, and vertigo.
Full recovery less likely with Ramsay Hunt syndrome
“Mild cases usually resolve within a few weeks, but more severe cases may take longer. In very severe cases, symptoms may not fully resolve,” said Ashley Lipps, MD, an infectious diseases physician at The Ohio State University Wexner Medical Center.
Lipps noted that routine childhood vaccination against chickenpox has reduced the risk of infection with the varicella-zoster virus (VZV) that also causes this condition.
She emphasized there is a vaccine available that could help adults.
“For those who have had chickenpox in the past, the shingles vaccine, for those who are eligible, can reduce the risk of developing shingles or Ramsay Hunt Syndrome,” said Lipps.
According to Chong, poor recovery can occur, especially if the paralysis is severe at onset, and recovery also seems worse in those with poor blood sugar control or if treatments are delayed.
“Some people will only make a partial recovery,” he said. “And in severe cases, that half of the face can be permanently paralyzed.”
Chong said that occasionally the healing process can go wrong, causing new symptoms.
“Sometimes, when the nerve regrows, some of the nerve fibers will follow the wrong tract and connect to the wrong target,” he said. “Which can cause some unusual contractions or twitches to occur, and sometimes the nerves to the salivary glands will end up connecting to the tear glands, causing ‘crocodile tears.’”
Treating Ramsay Hunt syndrome
According to Mount Sinai hospital in New York, treatment options for people with Ramsay Hunt syndrome include strong anti-inflammatory steroids like prednisone, and antiviral medicines like acyclovir or valacyclovir may also be given.
“Antiviral medications are only effective if given very early in the course of illness,” cautioned Lipps.
The bottom line
Justin Bieber recently said he’s experiencing Ramsay Hunt syndrome, a rare disorder that causes facial paralysis.
Experts say that the disease is caused by reactivated chickenpox virus and is sometimes associated with severe symptoms.
They also say that routine childhood vaccination against chickenpox, and shingles vaccine for those who have already had the disease, may help reduce our risk.