A 40-year-old woman attended the emergency department of the health centre for right unilateral otalgia and headache of 3 days' duration. She was treated as otitis externa with beclomethasone drops + clioquinol. The following day she returned to the emergency department for headache which subsided almost completely with intravenous analgesic therapy, adding dexketoprofen 25 mg/8 h to the previous treatment. Two days later he came to the consultation room reporting a throbbing headache, oppressive sensation at the periorbital level and tinnitus in the right ear, and the examination revealed no inflammation in the external auditory canal (EAC), selective hyperemia of the ossicular chain without tympanic alteration and discrete horizontal nystagmus, indicating treatment with levofloxacin 500 mg/24 h, betahistine and time off work. Two days later, he attended for the temporary incapacity report, reporting improvement of the ear pain, but a certain sensation of instability, and betahistine was replaced by sulpiride 50 mg/8h. Forty-eight hours later he consulted for "not feeling better"; he noted paresthesia in the right hemicara since that same morning, ageusia in the right hemilanguage and during the interview we observed blepharospasm in the left eye, confirming in the examination a right peripheral facial paralysis (facial asymmetry when smiling and blowing, as well as a slight right ocular opening when told to close his eyes), for which he was referred to the hospital emergency department for otorhinolaryngological assessment. Audiometry showed a slight drop in acuity in the right ear. Cranial nerves were normal except for VII. There was no spontaneous nystagmus. Otoscopy showed hyperemia in the upper portion of the CAE and small vesicles were visualized in the right auricle, so she was admitted with the diagnosis of "right Ramsay Hunt syndrome" to start treatment with intravenous acyclovir and evolutionary control.