Dr Kamala Kannan from Avadi has posted this article in IMA CGP WhatsApp journal with comments from Dr. Sridhar:

45 yrs old male with earache,deafness and vescicles over rt ear associated with rt sided facial palsy.

Ramsay Hunt Syndrome or Herpes otiticus
it is the herpes zoster infection of ear pinna and external auditory canal
5th and 8th cranial nerves may involved with this

Treat the pain as neuropathic
always r/o any immunocompromising conditions
famciclovir may be a better alternative for acyclovir

Sridhar B. Dr: Vesicles and crust over the Conchae,deafness and Ipsilateral Facial nerve falsy its likely to be RAMSAY HUNT SYNDROME…Its due to reactivation of VZV ie Herpes Zoster of Geniculate ganglion of facial nerve…Prognosis of this condition is relatively poor as COMPARED to Bells palsy.

Rx- Antiviral(Acyclovir or Valacyclovir)
Steroids(Oral)
Care of the eye
Physiotherapy

Sridhar B. Dr: Three different neurological syndromes carry the name of Ramsay Hunt syndrome. Their only connection is that they were all first described by the famous neurologist James Ramsay Hunt (1872–1937).

Ramsay Hunt syndrome type 1, also called Ramsay Hunt cerebellar syndrome, is a rare form of cerebellar degeneration which involves myoclonic epilepsy, progressive ataxia, tremor, and a dementing process.

Ramsay Hunt syndrome type 2 is the reactivation of herpes zoster in the geniculate ganglion. It is sometimes called herpes zoster oticus, and has variable presentation which may include a lower motor neuron lesion of the facial nerve, deafness, vertigo, and pain. A triad of ipsilateral facial paralysis, ear pain, and vesicles on the face, on the ear, or in the ear is the typical presentation.

Ramsay Hunt syndrome type 3 is a less commonly referenced condition, an occupationally induced neuropathy of the deep palmar branch of the ulnar nerve. It is also called Hunt’s disease or Artisan’s palsy.[4]