Man's earache leads to facial paralysis

Josh Dutton
·News Reporter
·2-min read

An elderly man’s earache has led to facial paralysis.

The man, 72, was rushed to the emergency room after one week of discharge from his ear and swelling, according to the case in the Annals of Emergency Medicine.

Two days before his hospitalisation he said his voice became hoarse, he felt increased dizziness and his face was beginning to droop.

Doctors noticed a “crusted rash” near his ear and the right, lower side of his face was experiencing paralysis, however he could still move both his eyebrows.

A man's ear is seen with a rash. He's also pictured trying to smile with partial face paralysis.
The man struggles to smile due to partial face paralysis and (left) his right ear is seen with a slight rash. Source: Annals of Emergency Medicine

There were concerns he had a form of palsy or facial weakness so a CT scan was performed.

“The result for urgent computed tomography of the head was unremarkable,” researchers wrote.

“Further examination revealed reduced blink rate on the right, sensorineural hearing loss on the right, dysphonia, and uvula deviation to the left. The results for the remaining cranial nerves and limb examination were normal.”

Dysphonia is when someone’s voice is abnormal — usually hoarse.

Ramsay Hunt syndrome diagnosed, same virus as chickenpox

Doctors diagnosed the man with Ramsay Hunt syndrome, which is normally characterised by facial paralysis and a rash around a person’s ear or mouth, like the patient in this case had.

As the Mayo Clinic describes it, Ramsay Hunt syndrome “occurs when a shingles outbreak affects the facial nerve near one of your ears”.

It can lead to a rash and hearing loss in that ear. A loss or distortion in taste, dry mouth and eyes, and ringing in the ears are among other symptoms.

Ramsay Hunt syndrome is caused by the same virus which gives people chickenpox.

As for the man, doctors noted it was “unexpected” he was still able to move both his eyebrows despite the diagnosis.

He was treated intravenously with antiviral medication.

While his facial paralysis eased, six months on in a follow-up appointment his right-side hearing loss remained.

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