The Doc Replies

Our expert answers your medical questions

Why do I still have facial paralysis six weeks after I was diagnosed with Ramsay Hunt syndrome?

Ramsay Hunt syndrome is when shingles affects the facial nerve near your ear. As well as a painful rash it can also cause facial paralysis and hearing loss in the affected ear.

It is caused by the chickenpox virus, which can hide in your nerve root and reactivate years later.

It’s more common when you get older and a vaccine for shingles is available for people over 70. Ramsay Hunt syndrome is not contagious. However, if somebody hasn’t had chickenpox before, they could catch it from the rash, so avoid physical contact with newborn babies and pregnant women.

In most cases, facial paralysis is temporary but if you are unlucky it can become permanent. It can also be difficult to close your eye properly, in which case an eye patch can avoid damage to the front of the cornea. Around one in five people with shingles can also get lasting pain, known as post-herpetic neuralgia. Treatment is generally a combination of antivirals and steroids, ideally given on the same day as symptoms first occur. The best chance of full recovery is after early treatment (within 72 hours) but we can’t predict if it will get better.

My partner cracks their knuckles. I find it annoying but is it harmful?

It has not been shown to be harmful. It’s caused by a negative pressure which pulls nitrogen gas temporarily into the joints, which causes the crack. Cracking your knuckles won’t damage your joints or lead to arthritis.

What are the key signs of malnutrition?

Malnutrition occurs when you don’t get enough nutrients in your diet. Signs are weight loss, tiredness, irritability, difficulty concentrating and feeling cold, depression, a lack of interest in food to drink. There are different types of malnutrition such as wasting, stunting and deficiencies in vitamins and minerals. You’d hope it would be less common in this country but, of course, sometimes people don’t eat properly. It’s important to have a varied diet rich in vitamins and minerals.

The Doc Replies

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