A man suffered a headache on
his flight. After arriving at the hotel, his left ear began hurting and soon
became excruciating.
When he opened the door, I
noticed that the left side of his face drooped.
Nothing pointed to the
usual ear infection. He had no cold symptoms. The plane’s descent did not
aggravate symptoms. He didn’t swim or use q-tips. He did not have a fever.
When I looked inside the
ear canal, I saw blisters.
Painful blisters in the
canal and a droopy face…. In forty years
of practice, I have never seen a case of Ramsay-Hunt syndrome, but there it
was. The poor man had shingles inside his ear.
Shingles is a viral infection
of skin nerves. It’s fairly common and usually appears as a patch of blisters
on the chest, abdomen, or back, sometimes the face. But there is skin in your
ear canal. An additional complication occurs because the nerve supplying the
ear canal also feeds muscles of the face, so victims suffer facial weakness on
that side.
Treatment is an antiviral
drug and a course of cortisone which is modestly but not dramatically
effective. Chances are he would recover completely, but he would have an
uncomfortable few weeks.
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