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What is Ramsay Hunt syndrome?

Justin Bieber announced that he is suffering from the syndrome, which is paralyzing half of his face. Experts say the outlook is good with early treatment.

WASHINGTON — The message was shocking and saddening to fans of Justin Bieber. The music megastar announced Friday that he was canceling his next few concerts because of a rare disorder called Ramsay Hunt syndrome.

"It is from this virus, attacks the nerves in my ear, my facial nerves, and has caused my face to have paralysis," Bieber said in a video posted to Instagram. 

The video has been viewed more than 32 million times, with legions of fans and colleagues leaving messages of love and support.

"I love you Bro! Rest up," wrote Nick DeMoura, a director, show designer and choreographer.

"I love you JB. You will defeat and overcome this," wrote Instagram user and podcaster Ben Baller. 

Bieber was scheduled to perform at the Capital One Arena in D.C. on June 10, but it was one of several performances that had to be canceled.

What Is Ramsay Hunt Syndrome?

A viral infection is behind Bieber's condition. Ramsay Hunt syndrome, also known as herpes zoster oticus, is a complication from shingles, according to the National Institutes of Neurological Disorders and Stroke, a division of the National Institutes of Health. 

Ramsay Hunt syndrome happens when a shingles outbreak affects the facial nerves near one of your ears. Shingles are caused by the varicella-zoster virus, which is the virus that causes chickenpox, the NIH said.  

"Shingles occurs in people who have had chickenpox and represents a reactivation of the dormant varicella-zoster virus," the NIH stated.   

Herpes zoster oticus happens when the varicella-zoster virus spreads to the facial nerves. It is known to cause intense ear pain, a rash and paralysis of facial nerves. The rash is most common around the ear, but can also be found around the mouth, face, neck and scalp.  

The NIH found that other symptoms may include hearing loss, vertigo (abnormal sensation of movement), and tinnitus (abnormal sounds). The health agency said taste loss in the tongue and dry mouth and eyes may also occur. 

Who Is At Risk for Ramsay Hunt Syndrome?

Experts at The Mayo Clinic said that Ramsay Hunt syndrome can happen to anyone who's had chickenpox.  

"Once you recover from chickenpox, the virus stays in your body — sometimes reactivating in later years to cause shingles, a painful rash with fluid-filled blisters," officials at the Mayo Clinic wrote.

Ramsay Hunt syndrome usually happens in adults older than 60 and is very rare in children. 

The Mayo Clinic says Ramsay Hunt syndrome isn't contagious; however, reactivation of the varicella-zoster virus can cause chickenpox in people who haven't previously had chickenpox or haven't been vaccinated for it. 

Treatment and Recovery

Antivirals or corticosteroids are often prescribed when needed to treat Ramsay Hunt syndrome. Experts say fast treatment can reduce complications.   

Mount Sinai medical experts said if there is not much damage to the nerve, most people should get better completely within a few weeks. If damage is more severe, some patients may not fully recover.  

Chances of recovery are better if the treatment is started within three days after the symptoms begin, according to Mount Sinai. 

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Complications include permanent hearing loss and facial weakness, eye damage and nerve pain.  

The Mayo Clinic stated the facial weakness caused by Ramsay Hunt syndrome may make it difficult for people to close their eyelids. When this happens, the cornea, which protects your eye, can become damaged, which can cause eye pain and blurred vision.

Post-herpetic neuralgia is described as a painful condition that happens when a shingles infection damages the nerve fibers. The Mayo Clinic said the messages sent by these nerve fibers become confused and exaggerated, causing pain that may last after other signs and symptoms of Ramsay Hunt syndrome are gone.

Ramsay Hunt syndrome is named after the American neurologist who identified it in the early 20th century.

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