(ORDO NEWS) — Justin Bieber had to cancel future concerts due to a viral infection that paralyzed one side of his face.
“As you can see, that eye doesn’t blink,” Bieber revealed to his fans in a recent video. “I can’t smile with this side of my face. This nostril does not move.”
The 28-year-old Canadian pop star has been diagnosed with Ramsay-Hunt Syndrome. It is caused by the varicella-zoster virus.
After a person has recovered from chickenpox, the virus can remain dormant in the body for decades. It usually hides in a structure called the dorsal root ganglion, a collection of nerve cells near the spinal cord.
As long as it is dormant, the virus does not cause any symptoms. In some people, it reactivates. This can happen spontaneously or by a known trigger such as another infection (including COVID-19), a weakened immune system, or stress.
All of this alters how the immune system works, allowing the varicella-zoster virus to come back into action and cause disease.
When the virus reactivates, it usually appears in one area of the body (often the trunk) as a painful rash and blisters known as shingles.
However, when the reactivation affects a nerve in the head called the facial nerve, it is known as Ramsay-Hunt syndrome, after James Ramsay-Hunt, the physician who first described the disorder in 1907.
Ramsey-Hunt syndrome typically affects five out of 100,000 people each year, and anyone who has had chickenpox has the potential to get it.
How the syndrome affects the body
The facial nerve leaves the brain to reach the face through a very narrow canal called the facial canal. One on each side of the brain to supply the left and right sides of the face.
This narrow bone tunnel is located inside a very dense piece of bone, so the slightest inflammation can lead to a pinched nerve. And because it is located deep in the skull, it is very difficult to treat.
The facial nerve travels part of its path with the vestibulocochlear nerve, which is involved in hearing and balance, so some people with Ramsay-Hunt syndrome also have hearing problems, such as tinnitus, and sometimes balance problems.
The symptoms of this syndrome vary from case to case, but there is usually a paralysis of the facial nerve, which innervates the facial muscles, making it difficult to smile or frown. It can also limit the ability to blink, and some people have slurred speech and changes in taste.
The painful rash usually appears on and around the ear, on the same side as the paralyzed parts of the face. This rash is a clear sign that it is not Bell’s palsy (another type of facial palsy).
One of the complications of Ramsey-Hunt syndrome is the possibility of damage to the cornea of the eye (through which light passes for vision).
This is due to the lack of blinking, which helps to lubricate the eyes. The facial nerve also innervates the lacrimal gland, which can also be paralyzed. This gland produces a fluid that lubricates the eyes.
Is it curable?
People with Ramsey-Hunt syndrome may need to lubricate their eyes with artificial tears. And the affected eye must be sealed at night. Treatment is usually with antiviral drugs, steroids, and pain medication. The chances of a full recovery are higher if treatment is started early.
If treatment is given within three days of the onset of symptoms, about 70% of people make a full recovery. But if treatment is not started during this period, the probability of complete recovery drops to 50%.
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