Abstract
Background and purpose: Ramsay Hunt Syndrome is an uncommon diagnosis that has as part of its presentation unilateral facial paralysis. Functional limitations can include: asymmetric facial expression and difficulty speaking, drinking and eating. The most effective treatment is not clear based on published research. The following case study describes the use of various interventions to assist in facial muscle activation in a patient diagnosed with Ramsay Hunt Syndrome. Case description: A 55 year old female patient presented with right sided facial paralysis two months after diagnosis of Ramsay Hunt Syndrome. The patient received progression of range of motion exercises, neuromuscular re-education, soft tissue mobilization, and trials of electrical stimulation as outlined in the current research. In conjunction, she received instruction and application of kinesthetic taping to facilitate and/or inhibit facial muscle activation. The patient was seen for 21 visits over a 14 month time period. Outcomes: House Brackmann grades improved from a grade V to a grade II. Strength increased from 1- to 4+. Functional improvements included improvements in communication, eating/drinking, and facial symmetry at rest. The patient also reported significant improvement in experienced pain. Presence of watery eye, and synkinesis were still mildly observed. Discussion: Limited research is available regarding the treatment of Ramsay Hunt Syndrome. The combination of interventions described in this report was observed to improve muscle activation, facilitate a decrease in pain, and coincide with an improved House Brackmann grade. Further research should include randomized controlled trials to explore the cause and effect of each treatment.
Highlights
Research describing physical therapy interventions for patients diagnosed with Ramsay Hunt Syndrome is limited. [1,2]
Limited research is available regarding the treatment of Ramsay Hunt Syndrome
Estimates indicate that twenty-five in 100,000 people in the United States are affected with unilateral facial paralysis, 5.7% are diagnosed as suffering from Ramsay Hunt Syndrome [4]
Summary
Ramsay Hunt Syndrome is a rare diagnosis. The research supporting treatment interventions is often conflicting [1,2,9,23,24,25]. Further randomized controlled studies are needed to evaluate the degree to which any of these interventions might play a positive role in treatment for patients with facial paralysis The purpose of this case report was to demonstrate multi-faceted physical therapy plan of care for the treatment of facial muscle paralysis in a patient diagnosed with Ramsey Hunt Syndrome. This treatment program and the course of the syndrome progression resulted in outcomes of improved House Brackmann grade, facial muscle strength, visualized improvements through photographs and most importantly functional and social gains
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
