Which findings comprise the Ramsay Hunt triad?

• A. Migratory joint pain
• B. Hearing loss and vertigo without facial weakness
• C. Ipsilateral facial paralysis, ear pain, vesicles in auditory canal or auricle
• D. Headache and fever only

Answer: (C)

Ramsay Hunt syndrome arises from reactivation of varicella-zoster virus in the facial nerve and presents with a distinctive cluster of findings on the same side of the head. The defining triad includes: ipsilateral facial nerve paralysis (facial weakness on the same side), ear pain (otalgia) due to inflammation of the nerve, and vesicular eruption in the ear canal or on the auricle. This combination—facial weakness plus ear pain and vesicles in the ear region—is why this option is the best match.

Hearing loss, vertigo, and other symptoms can occur with this condition because the virus can involve nearby structures, including the vestibulocochlear nerve, but they are not required to establish the triad. Conversely, migratory joint pain or headaches with fever alone do not capture the key nasal features of Ramsay Hunt.