Justin Bieber, 28, has put his Justice World Tour on hold due to a viral infection that has paralysed half his face. "As you can see, this eye is not blinking, I can't smile on this side of my face, this nostril will not move," Bieber said in a video. “So, there's full paralysis on this side of my face. So, for those who are frustrated by my cancellations of the next shows, I'm just physically, obviously, not capable of doing them. This is pretty serious, as you can see,’’ he said.
Ramsay Hunt Syndrome, the infection that Justin Bieber has been diagnosed with, is a viral infection caused by varicella-zoster virus (VZV) that belongs to the herpes virus group.
Ramsay Hunt Syndrome is a rare condition. “We only get 4-5 patients infected with the virus in a year,” says Dr Rohit Shetty, vice chairman, Narayana Nethralaya, Bengaluru.
Ramsay Hunt Syndrome affects the geniculate ganglion of facial nerve. “The facial nerve near the inner ear gets infected leading to irritaion and swelling of the nerve,” says Dr Vipasha Brajpuriya, senior consultant and unit head, ENT, Accord Superspecialty Hospital, Faridabad.
Humans have 12 cranial nerves. “The seventh cranial nerve is affected by the virus. It makes the nerve conduction ineffective,’’ says Shetty. Other cranial nerves could also be involved.
Ramsay Hunt Syndrome typically presents with painful vesicular rashes over the external ear (pinna), ear canal, ear drum and same-sided facial nerve paralysis, says Dr H.K. Susheen Dutt, senior consultant - ENT specialist, Bannerghatta Road, Bengaluru. Tinnitus, giddiness, and hearing loss are all possible symptoms.
The infection can cause severe pain on the affected side. “It is very troubling and disturbing condition,” says Dr Swapnil Brajpuria, senior consultant - ENT, Asian Institute of Medical Sciences, Faridabad. So, how is the infection diagnosed? "For diagnosis, we can do blood tests for varicella zoster virus antibodies, audiometry for hearing loss, electromyography for facial nerve dysfunction, MRI brain,” says Brajpuria.
If damage to the nerve is not severe, the patient gets well within a few weeks, or else it takes longer.
Ramsay Hunt Syndrome can be treated with antiviral drugs like acyclovir and valacyclovir and oral steroids like methylprednisolone to decrease the inflammation. "Effective pain killers are also required to ease the disabling pain. Eye care is usually required to avoid corneal ulceration," says Brajpuria. Facial nerve rehabilitation exercises are also recommended for patients suffering from this condition.
Bieber is doing facial exercises besides using the time off to "rest and relax and get back to 100 per cent so I can do what I was born to do".
