What are the symptoms of Ramsay Hunt syndrome?

• A. Fever and sore throat
• B. Chest pain
• C. Chronic cough
• D. Painful blistering rashes around the ear, facial paralysis, hearing loss, vertigo

Answer: (D)

Ramsay Hunt syndrome is herpes zoster oticus from reactivation of varicella zoster virus in the facial nerve pathway. The defining feature is a painful, vesicular rash around the ear (often in the external auditory canal or auricle) combined with ipsilateral facial nerve palsy. Because the seventh cranial nerve is involved, you get facial weakness, and because the eighth nerve can be affected, there are hearing changes and vertigo (with possible tinnitus). This specific combination of a painful ear-area rash plus facial paralysis and vestibulocochlear symptoms is what distinguishes Ramsay Hunt syndrome from other conditions. The other options describe nonspecific viral symptoms or chest/airway-related issues, not this ear-centered constellation.