On an Instagram video posted last Friday, Justin Bieber announced that his face has been partially paralyzed. One side of his face is unable to smile, and one eye isn’t able to blink. According to the singer, he has a condition called Ramsay Hunt syndrome.

“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 on Instagram. The pop star added that he needed to postpone some of his shows because he’s “physically, obviously, not capable of doing them.”

But what exactly is Ramsay Hunt syndrome?

What is Ramsay Hunt syndrome?

Also known as herpes zoster oticus, Ramsay Hunt syndrome is a rare neurological disorder where facial nerves are paralyzed and rashes appear around the mouth or ears. It is named after the physician James Ramsay Hunt, who first diagnosed the syndrome in 1907.

While it is more common in adults than children, the syndrome is so rare that only 5 out of every 100,000 people in the United States contract it.

What is its cause?

The syndrome is caused by the Varicella zoster virus (VZV), which is also the same virus that leads to chickenpox and shingles. Anyone who has contracted chickenpox as a child may eventually develop Ramsay Hunt syndrome. This is because the virus from which both diseases come from may remain dormant for many years and only reactivate as an adult. Unfortunately, there is no known cause yet why the virus reactivates.

What are the symptoms?

When a person contracts Ramsay Hunt syndrome, their symptoms can vary from others. It may be one or the combination of the following:

• facial nerve paralysis, which may manifest in:
  • weak or stiff facial muscles
  • difficulty in smiling
  • closed eye on the affected side
  • slurred speech
• rash affecting the mouth or ears
• ringing in the ears
• ear pain
• nausea
• vomiting
• vertigo

In his video, Justin Bieber said he showed how he had some of these symptoms, especially facial nerve paralysis. “As you can see this eye is not blinking. I can’t smile on this side of my face; this nostril will not move. So there’s full paralysis on this side of my face.”

Is it contagious?

Ramsay Hunt syndrome itself is NOT contagious. But those who have it may pass on the virus and cause chickenpox in others who haven’t contracted it before or haven’t been vaccinated against it.

If one has Ramsay Hunt syndrome, it’s best to avoid people who haven’t contracted chickenpox or haven’t been vaccinated against it; and people who have a weak immune system (e.g. elderly, newborns, children, pregnant women).

Are there any risks or complications?

Should the disorder not be immediately detected and treated, complications may quickly arise. These include:

• permanent facial paralysis
• permanent hearing loss
• eye damage (due to the inability to close your eye because of Ramsay Hunt syndrome)
• postherpetic neuralgia (a condition of damaged nerve fibers due to shingles or rash infection)

Is there a treatment?

There is treatment, which usually involves antiviral medications such as acyclovir or famciclovir. These are taken with corticosteroids, like prednisone, for pain and swelling.

If a patient still finds difficulty in moving their facial muscles even after completing their medication, they may be advised to undergo physical therapy to train their muscles again.

Justin Bieber assured his fans that he is undergoing treatment and doing “facial exercises to get my face back to normal.”

How long does it take to recover?

It varies from patient to patient. But if treated early, a patient may recover from a couple of weeks to several months. However, if treated late, there is a lower chance for a full recovery.

How do you prevent it?

While there is no known way to prevent the syndrome from developing, it’s best to get vaccinated against chickenpox as early as childhood, since the two diseases come from the same virus. If you have a weak immune system, it’s best to be careful and avoid anyone who may be infected.

Despite the difficulty he is experiencing in moving half of his face, Justin Bieber assured his fans that everything is going to get better. “It will go back to normal. It’s just time and we don’t know how much time, but it’s going to be OK,” he added after his announcement. “Obviously, my body’s telling me I gotta slow down. I hope you guys understand and I’ll be using this time to just rest and relax and get back to 100%.”