Inflammation of the geniculate ganglion of the facial nerve is a late consequence of varicella zoster virus (VZV) known as Ramsay Hunt syndrome (RHS), commonly known as herpes zoster oticus. In regards with the frequency, less than 1% of varicella zoster infections involve the facial nerve and result in RHS. It is traditionally defined as a triad of ipsilateral facial paralysis, otalgia, and vesicles close to the ear and auditory canal. Due to its proximity to the vestibulocochlear nerve, the virus can spread and cause hearing loss, tinnitus (hearing noises that are not causes by outside sounds), and vertigo. It is common for diagnoses to be overlooked or delayed, which can raise the likelihood of long-term consequences. It is more complicated than Bell's palsy. Therapy aims to shorten its overall length, while also providing pain relief and averting any consequences. Signs and symptoms Early symptoms include intense pain in one ear, the jaw on one side or the neck on one side which may precede the acute facial paralysis by a week or more. Acute symptoms include: acute facial nerve paralysis pain in the ear, jaw and/or neck taste loss in the front two-thirds of the tongue dry mouth and eyes an erythematous vesicular rash in the ear canal, the tongue, and/or hard palate. Because the vestibulocochlear nerve is in proximity to the geniculate ganglion, it may also be affected and patients may also experience: tinnitus hearing loss hyperacusis vertigo The swallow reflex might also be affected. Involvement of the trigeminal nerve can cause numbness of the face. Pathophysiology The varicella zoster virus infects people and results in a distributed vesicular rash with fever, known as chickenpox. Respiratory droplets are the main method of virus transmission during the acute stage of the infection. After it subsides, it stays dormant in nerve cells in the body. It may reactivate under conditions of physiological stress or if the immune system is suppressed in any way (for example during an illness or undergoing chemotherapy), resulting in herpes zoster, also known as shingles or Ramsay Hunt syndrome when facial paralysis in involved. If the nerve cells affected lie within the facial nerves, it causes the symptoms described above. Ramsay Hunt Syndrome Type 2 is estimated to account for 12% of all facial nerve paralysis. It occurs in both immunocompetent and immunocompromised individuals with immunocompromised patients often having more severe disease presentation. RHS may occur