Laryngeal zoster with multiple cranial nerve palsies

Bossche, Paul Van Den; Bossche, Karolien Van Den; Vanpoucke, Hilde

doi:10.1007/s00405-007-0434-6

Cited by 27 publications

(17 citation statements)

References 8 publications

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“…Common triggers for reactivation of latent VZV include emotional stress, physical trauma, smoking, recent viral infection and decreased cell-mediated immunity, either as a feature of advancing age or immunocompromised states 3. The severity and duration of symptoms is often greater in the elderly 4 5…”

Section: Discussionmentioning

confidence: 99%

Herpetic cranial polyneuritis mimicking brain stem infarction—an atypical presentation of Ramsay Hunt syndrome

Bharadwaj¹,

Moffat

Wood

et al. 2016

BMJ Case Reports

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An elderly man presented with severe right ear pain and discharge, hoarseness and dysphagia causing significant involuntary weight loss. Extensive investigations by varied specialties only highlighted right vocal cord palsy and right parotid lymphadenitis. Reassessment on transfer to a rehabilitation ward noted clinically subtle right Ramsay Hunt syndrome with multiple lower cranial nerve involvement. We illustrate a case of varicella zoster virus cranial polyneuritis with bulbar symptoms mimicking bulbar stroke, requiring percutaneous endoscopic gastrostomy feeds, with significant clinical and radiological recovery over 1 year.

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Section: Discussionmentioning

confidence: 99%

Herpetic cranial polyneuritis mimicking brain stem infarction—an atypical presentation of Ramsay Hunt syndrome

Bharadwaj¹,

Moffat

Wood

et al. 2016

BMJ Case Reports

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“…Herpes zoster laryngitis usually indicates a presenting symptom that manifests as laryngeal mucosal eruptions 4, 7. When it is associated with vocal cord palsy, it is a condition known and infrequently reported as laryngeal zoster,2, 6 which may be further associated with prelaryngeal skin erythema 5. VZV involved in the larynx may also mimic a laryngeal cancer by presenting a laryngeal mass with multiple cranial neuropathies 1.…”

Section: Discussionmentioning

confidence: 99%

“…In the absence of related herpes zoster oticus, herpes zoster of the laryngeal region with cranial nerve palsy with or without facial nerve involvement is not common and is only reported in a limited body of literature 2–7. To the best of our knowledge, herpetic eruptions involving the sensitization area of both the glossopharyngeal nerve and vagus nerve and associated with unilateral facial paralysis and sensorineural hearing loss (SNHL) has never been reported in the literature in English.…”

Section: Introductionmentioning

confidence: 99%

Varicella zoster virus infection of the pharynx and larynx with multiple cranial neuropathies

2011

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Varicella zoster virus (VZV) infection of the head and neck region may present with various clinical symptoms, involving different entities and different routes of viral spreading. We present a case of VZV infection of the pharynx and larynx with multiple cranial nerve (CN) neuropathies (CN VII, VIII, IX, and X) of a 52-year-old woman who complained of the sudden onset of hoarseness, odynophagia, dysphagia, and hearing loss in the left ear, followed by left-side facial weakness lasting for 1 week. Endoscopic examination revealed multiple mucosal erosions over the oropharynx, with extension upward to the nasopharynx and downward to the mucosa overlying the epiglottis, arytenoid, and vocal cord. All of these lesions tended to lateralize to the left side, suggesting a VZV infection diagnosis; this was confirmed by polymerase chain reaction on eruptional exudates, as well as serologic examination.

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“…If there is unilateral herpes zoster infection of the larynx, insilateral LCN may be affected [10]. Our case had a diagnosis in VZV antibody in the CSF similarly.…”

Section: Discussionmentioning

confidence: 61%

The Importance of Rehabilitation of Varicella Zoster Virus Neuropathy with Dysphagia: A Case Report and Literature Review

Nagai¹,

Ito²,

Nishizaka³

et al. 2017

Int J Phys Med Rehabil

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Dysphagia due to the varicella zoster virus (VZV) infection has the type of the main constituent Hunt syndrome and dysphagia of the main constituent a facial paralysis. The difference is considered to be the thing due to the ganglionic site which a virus reactivated. We report a case of the rehabilitation for dysphagia due to the VZV viral infection. Keywords: Rehabilitation; Varicella zoster virus; Dysphagia Case ReportA 76-year-old-female patient came to a nearby hospital with a sore throat and hoarseness in August, 2016. In acknowledgement of laryngeal edema, she was admitted to other hospital and did tracheotomy. There was the remaining, but the remaining was able to be eliminated by adding deglutition in the videofluorography at admission.VZV IgG rose by a blood test, and VZV virus neuropathy with dysphagia was diagnosed. She was admitted to the hospital for rehabilitation 65 days later. The Barthel index (BI) was 80 point and she had diabetes, hypertension, a gastric ulcer, but the control was good. The soft palate and lingual were normal. Left vocal cord paralysis was detected in swallowing videoendoscopy (VE) at admission, and the left vocal cord was fixed in a cadaveric position (Figure 1). Also, a larynx had remaining swallowing videofluorography (VF), but the remaining removal was possible in additional deglutition and compensation movement (Figure 2).There was a larynx invasion and a diet was paste foods and ate in 60 degrees reclining position, cervical rotation rank. The rehabilitation program trained her for dysphagia directly and conducted muscular strength reinforcement for muscle weakness. The diet was ingested by tube feeding two weeks before she was admitted, and she continued a paste meal after admission. There was not the aspiration in 90 degrees She removed a cannula 109 days after the onset, and became calm and finally became able to almost take in general diet with nothing. The ADL became independent, and the FIM became 126 points and became the home discharge 131 days after the onset. In VE at discharge, pharyngeal paralysis was improved and there was not the velopharyngeal insufficiency (Figures 3 and 4). Figure 4: There was the remaining, but the larynx movement was improved in the videofluorography at discharge. International Journal of PhysicalMedicine & Rehabilitation Nagai et al., Int J Phys Med Rehabil 2017, 5:In VF at discharge, a larynx had the remaining, but the movement was improved. Because a little larynx invasion was found when we consumed water, we taught it to drink by small quantity. DiscussionThe cause of the mixed laryngeal nerve paralysis is vascular and is neoplastic, and there is postoperative infectivity. The reports of the viral mixed laryngeal nerve paralysis increased [1][2][3][4][5][6][7].The diagnosis is confirmed by demonstration of VZV-DNA or VZV-antibodies in the CSF [8,9]. If there is unilateral herpes zoster infection of the larynx, insilateral LCN may be affected [10]. Our case had a diagnosis in VZV antibody in the CSF similarly.As for the tr...

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Laryngeal zoster with multiple cranial nerve palsies

Cited by 27 publications

References 8 publications

Herpetic cranial polyneuritis mimicking brain stem infarction—an atypical presentation of Ramsay Hunt syndrome

Herpetic cranial polyneuritis mimicking brain stem infarction—an atypical presentation of Ramsay Hunt syndrome

Varicella zoster virus infection of the pharynx and larynx with multiple cranial neuropathies

The Importance of Rehabilitation of Varicella Zoster Virus Neuropathy with Dysphagia: A Case Report and Literature Review

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