What is Ramsay Hunt syndrome, which Justin Bieber says caused his facial paralysis?

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Canadian singer Justin Bieber announced this week that he had postponed his next few concerts as he was suffering from facial paralysis, a result of Ramsay Hunt syndrome.

It is caused by a virus that attacks nerves in his face and ears and, according to the Mayo Clinic, occurs when a shingles outbreak affects the facial nerve near one of your ears. Dr. Charles Nduka, a consultant plastic reconstructive surgeon in Britain, said people who have the syndrome had a viral infection at some point in the past and it is a reactivation of that previous infection.
"(It's) much the same way that people who develop shingles, a sudden rash, will have had the infection some time previously, typically with chickenpox," he said.

Nduka added that a "significant factor" is usually the people who develop Ramsay Hunt will have another issue going on that causes their immune system to be depressed, giving physical stress or even emotional stress as a cause.

The surgeon also advised that overall, patients with the syndrome who receive the appropriate treatment at the right time should see about a 70-75 per cent rate of full recovery. However, those who do not receive treatment — specifically steroids and antivirals "in a timely manner, may have closer to a 50 per cent chance of recovery.