What to Know About Ramsay Hunt Syndrome After Justin Bieber's Diagnosis

"This is pretty serious as you can see," Justin Bieber previously told fans as he revealed his diagnosis with Ramsay Hunt syndrome and the resulting partial facial paralysis

Justin Bieber
Photo: Justin Bieber/Instagram

Justin Bieber revealed Friday that he was diagnosed Ramsay Hunt syndrome, which has resulted in partial facial paralysis.

After postponing three shows on his Justice World Tour earlier this week due to an ongoing health issue, the Grammy Award winner, 28, opened up about his diagnosis in a video on Instagram, revealing the neurological disorder's physical effects.

"Hey everyone. Justin here. I wanted to update you guys on what's been going on," Bieber said. "Obviously, as you can probably see from my face, I have this syndrome called Ramsay Hunt syndrome, and it is from this virus that attacks the nerve in my ear and my facial nerves and has caused my face to have paralysis."

He explained that he's unable to blink one of his eyes, move his nostril or smile on one side of his face, adding in a followup on his Instagram Story that it's gotten "progressively harder to eat." Additionally, Bieber asked for his 240 million Instagram followers to keep him in their prayers.

"This is pretty serious as you can see. I wish this wasn't the case but obviously, my body is telling me I got to slow down, and I hope you guys understand, and I'll be using this time to rest and relax and get back to 100 percent so that I can do what I was born to do," Bieber added.

NEW YORK, NEW YORK - SEPTEMBER 13: (L-R) Justin Bieber and Hailey Bieber attend The 2021 Met Gala Celebrating In America: A Lexicon Of Fashion at Metropolitan Museum of Art on September 13, 2021 in New York City. (Photo by Kevin Mazur/MG21/Getty Images For The Met Museum/Vogue)
Justin Bieber. Kevin Mazur/MG21/Getty

Dr. Amit Kochhar, MD, board-certified otolaryngologist (ENT) and director of the Facial Nerve Disorders Program at Pacific Neuroscience Institute at Providence Saint John's Health Center in Santa Monica, California, tells PEOPLE about the "very, very rare" disorder.

Here's what to know about Ramsay Hunt syndrome.

What Is Ramsay Hunt Syndrome?

Ramsay Hunt syndrome is the second most common cause of atraumatic peripheral facial paralysis, after Bell's Palsy, but slightly more severe. Still, it only occurs in around five in 100,000 people.

It's caused by a shingles virus reactivation in the face, which makes people who had chicken pox of varicella-zostar virus as a child susceptible.

What Are the Causes?

Ramsay Hunt is caused by times of high stress or immunosuppression, as well as by immunosuppressant drugs or other underlying conditions. "Your body just can't fight off infection," Dr. Kochhar explains.

The virus that causes chicken pox stays dormant in the body until something triggers it, returning in form of herpes zoster (Ramsay Hunt), which can inflame different nerves in the abdomen, back and face.

What Are the Symptoms?

The facial paralysis is caused by a nerve that comes from the brain and travels through "a tunnel" of bone, allowing facial expressions and the ability to convey emotion. When it becomes inflamed, the nerve expands but the bone doesn't move.

"Essentially, it crushes the nerve," Dr. Kochhar says.

Other side effects include hearing loss, severe vertigo and rashes or blisters that occur on the ear or cheek. Headaches and vomiting are also common.

How Is It Treated?

Once diagnosed, Ramsay Hunt can be treated with high dose steroids and antivirals, which can be taken orally at home and are "the most important thing" for recovery. For more severe cases, patients will be admitted to the hospital, where they will receive medications via IV.

Dr. Kochhar warns patients that, although electrical stimulation to the face may be recommended by some to get the muscles to work, it's "very discouraged" and is known to "cause very severe side effects and impair the recovery."

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"That has been found to contribute to the longterm nerve damage and muscle spasms," he adds.

The doctor also notes that, although there is "really no role in the early phase of treatment" for things like facial exercises, acupuncture or massages, those can be helpful further down the road. "It's really just a matter of letting your face recover," Dr. Kochhar says.

What Are the Longterm Effects?

Although around 75 percent of patients will recover completely, the other 25 percent "will develop some type of longterm nerve damage," which Dr. Kocchar treats at his practice.

He notes that longterm effects include unwanted facial spasms, tightness or discomfort, and in "the most severe cases," there will be facial asymmetry, which is most visible in facial expressions. These side effects are more likely in patients who take longer than a month or two to recover.

"There's no way to know who's going to develop longterm issues," Dr. Kocchar says, adding: "If they recover within the first three to four weeks, usually they'll have a pretty good chance of a clean recovery."

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