The first weeks: medical treatment
Ramsay Hunt syndrome is caused by the shingles virus (varicella-zoster) reactivating near the facial nerve. In the first days, see a doctor straight away. Treatment usually combines an antiviral with a steroid such as prednisone, ideally started within 3 days, plus pain relief and eye protection.
Read more in What is Ramsay Hunt syndrome? and Ramsay Hunt syndrome vs Bell’s palsy.
Long-term effects we treat
From about 8 months after the onset, with no upper limit:
- Synkinesis: the eye closing when you smile, the mouth moving when you blink
- An uneven smile and facial asymmetry
- Facial tightness and pain, neck and mouth tension
- Dry eye or crocodile tears
Our approach
We see the long-term effects of Ramsay Hunt syndrome as patterns the brain learned during the long recovery, which means they can be retrained. Our Neuro-Proprioceptive Rehabilitation method helps the brain send balanced signals to both sides of the face again.
- Non-invasive and painless: no Botox, fillers, surgery or electrical stimulation.
- Usually 6 to 12 months, with daily practice at home.
- Measured progress: in the clinic we do a Nerve Conduction Study and Synkinetic Correlation Analysis before and during the program.
In the clinic, online or both
| Program | Best for | More |
|---|---|---|
| In the clinic | The best possible result, complex or long-standing cases | In-clinic program |
| Hybrid | One or two clinic visits for measurements, the rest online | Hybrid program |
| Online | Milder effects, or when you cannot travel | Online program |
Coming from abroad
We space clinic visits 10 to 12 weeks apart for patients from abroad, or work fully online. Most patients fly into Amsterdam Schiphol and take the direct train to Rotterdam Centraal. The Postillion Hotel is in the same building as the clinic. More in When you visit us in Rotterdam.
What our patients say
- Gabriela: a TV reporter from Rio de Janeiro who could no longer present the news after Ramsay Hunt syndrome. Two years after the onset, she finished her rehabilitation after four clinic visits: “My face is more balanced and symmetrical.”, Gabriela’s Ramsay Hunt recovery story
- Staci (USA): discharged by three healthcare systems, she regained eye closure and her smile with a mix of clinic and online sessions.
Costs
The first step is a video consultation with Dr. Pashov of about 40 minutes. We analyse your case, explain what you can realistically expect and which program fits best. The cost of a full program depends on the option you choose and how many sessions you need. We discuss this in the consultation, and you decide afterwards.
See the consultation page and the program pages for prices.
Frequently Asked Questions
Can Ramsay Hunt syndrome be treated years later?
Yes, its long-term effects can. We treat patients from about 8 months after the onset with no upper limit, including those who had Ramsay Hunt syndrome 10 or more years ago.
Why is recovery from Ramsay Hunt syndrome harder than from Bell's palsy?
The virus usually damages the facial nerve more deeply, so the nerve needs longer to regrow. A longer recovery makes synkinesis and other lasting effects more likely.
Do you treat the acute phase of Ramsay Hunt syndrome?
The acute phase needs a doctor: antivirals and steroids, ideally within 3 days. We help with the long-term effects, and a video consultation can help you understand your recovery at any stage.
Can I do the rehabilitation online?
Yes. In the online program you learn the techniques in video sessions and practise at home. A hybrid program adds one or two clinic visits.
Do you use Botox or surgery?
No. We use the Neuro-Proprioceptive Rehabilitation method only.
