hyperactive muscles and synkinesis, both of which are permanent. The most common form of synkinesis for Ramsay Hunt Syndrome patients involves the eye being connected to the mouth (i.e. blinking while speaking, tearing while eating) and chin dimpling (chin dimples forming when speaking). Many forms of synkinesis can be managed with use of medical Botox administered by a qualified doctor. Prognosis Overall between 30% and 70% of Ramsay Hunt syndrome type 2 patients recover most functionality depending on early diagnosis and treatment with chances of recovery dropping to 50% if treatment is delayed beyond 72 hours. Once the active infection has been cleared with antivirals, the facial nerves will begin to regrow at approximately 1mm per day. The recovery process for Ramsay Hunt syndrome is significantly longer than Bell's palsy. On average, Ramsay Hunt syndrome patients begin to see their symptoms resolve between 5 and 12 months post diagnosis and can expect to see continued resolution of symptoms for up to 2 years post diagnosis. Occasionally, patients may experience minor improvements beyond 2 years. The order in which symptoms resolve is highly individual. Although most patients will experience some recovery; complete recoveries with no lingering symptoms are in the minority. The main factors affecting the overall prognosis are the severity of symptoms at onset, the age and general health of the patient and the timing of initial treatments Common long term effects include: Permanent facial paralysis of some or all of the affected facial nerves Corneal abrasion and/or ulcers if proper care is not taken of the affected eye which may affect long-term vision Neuropathic pain and post-herpetic neuralgia can commonly persist for more than 3 months and a year to 18 months is not uncommon. More than 50% of patients report experiencing post-herpetic neuralgia. Post-herpetic fatigue is also a common long term side effect and may persist for several months to a year or more. Weakness in the affected facial muscles Sensitivity to cold and heat in the affected facial muscles Synkinesis including eye fluttering, chin dimpling and eye watering Hyperactive muscles that contract inappropriately Less common long term effects include: Verbal processing deficits including speaking the incorrect word (aphasia) Memory deficits including failures in short-term memory Vertigo Partial or full hearing loss Hyperacusis Hyperactive muscles particularly in the neck and cheek Tinnitus Some patients report an increased sensitivity to barometric pressure with changes in weather patterns causing pain