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Unilateral associated laryngeal paralysis due to varicella-zoster virus: virus antibody testing and videofluoroscopic findings

Published online by Cambridge University Press:  16 November 2007

S-I Chitose*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Fukuoka, Japan
H Umeno
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Fukuoka, Japan
S Hamakawa
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Fukuoka, Japan
T Nakashima
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Fukuoka, Japan
H Shoji
Affiliation:
First Department (Neurology) of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
*
Address for correspondence: Dr Shun-ichi Chitose, Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. Fax: +81 942 37 1200 E-mail: [email protected]

Abstract

The relationship between varicella-zoster virus and idiopathic associated laryngeal paralysis was examined in five patients, using complement fixation or enzyme immunoassay testing. In all cases, significant changes in serum levels of varicella-zoster virus antibody were observed. Videofluoroscopy was useful in assessing the severity of the dysphagia and in making an accurate diagnosis; both laryngeal elevation and weakness of pharyngeal wall contraction were also observed. In two cases in which antiviral therapy was delayed, the outcome was poor, with increased levels of varicella-zoster virus immunoglobulin M found on enzyme immunoassay. The outcome of the condition may thus depend both on the speed of antiviral therapy commencement following onset of symptoms, and on the levels of varicella-zoster virus immunoglobulin M antibody (measured by enzyme immunoassay). Our study suggests that varicella-zoster virus should be considered in the differential diagnosis of patients with idiopathic associated laryngeal paralysis, and rapid antiviral therapy should be initiated when necessary.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2007

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References

1 Hunt, JR. On herpetic inflammation of the geniculate ganglion. A new syndrome and its complications. J Nerv Ment Dis 1907;34:7396CrossRefGoogle Scholar
2 Hunt, JR. The symptom-complex of the acute posterior poliomyelitis of the geniculate, auditory, glossopharyngeal and pneumo-gastric ganglia. Arch Intern Med 1910;5:631–75Google Scholar
3 Negus, VE, Crabtree, NC. A case of herpes zoster of the VIIth, IXth and Xth cranial nerves. J Laryngol Otol 1943;58:192–5Google Scholar
4 De, S, Pfleiderer, AG. An extreme and unusual variant of Ramsay Hunt syndrome. J Laryngol Otol 1999;113:670–1CrossRefGoogle ScholarPubMed
5 Takei, S, Sato, R, Nishizaka, A, Imaizumi, T, Ayabe, M, Shoji, H. Unilateral lower cranial nerve palsies due to varicella-zoster virus in the absence of rash: a report of two cases. Neuroinfection 2004;9:8991Google Scholar
6 Miyazaki, Y, Tajima, Y, Sudo, K, Matsumoto, A, Kikuchi, S, Tashiro, K. A case of Ramsay Hunt syndrome initiated with hoarseness and dysphagia: consideration on spreading mechanisms of cranial neuropathy [in Japanese]. Rinsho Shinkeigaku Clin Neurol (Tokyo) 2002;42:855–8Google Scholar
7 Payten, RJ, Daws, JD. Herpes zoster of the head and neck. J Laryngol Otol 1972;86:1031–55CrossRefGoogle ScholarPubMed
8 Pahor, AL. Herpes zoster of the larynx; how common? J Laryngol Otol 1979;93:93–8CrossRefGoogle ScholarPubMed
9 Osaki, Y, Matsubayashi, K, Okumiya, K, Wada, T, Doi, Y. Polyneuritis cranialis due to varicella-zoster virus in the absence of rash. Neurology 1995;45:2293Google Scholar
10 Djupesland, G, Degre, M, Stien, R, Skrede, S. Acute peripheral facial palsy; part of a cranial polyneuropathy? Arch Otolaryngol 1977;103:641–4Google Scholar
11 Engström, H, Wohlfart, G. Herpes zoster of the seventh, eighth, ninth and tenth cranial nerves. Arch Neurol Psychiatry 1949;62:638652CrossRefGoogle ScholarPubMed
12 Miyata, K, Nagata, T, Yamamoto, M, Kaneko, K, Asato, R. Herpes zoster of larynx; a report of 2 cases [in Japanese]. Pract Otol (Kyoto) 2001;94:1007–11Google Scholar
13 Mizutari, K, Saito, H, Ozawa, H. Herpes zoster involving lower cranial nerve; a report of 2 cases [in Japanese]. Pract Otol (Kyoto) 2002;95:889–92Google Scholar
14 Ishikawa, T, Tojima, H. Three cases of lower cranial nerve involvement with herpes zoster. Pract Otol (Kyoto) 2002;95:441–6Google Scholar
15 Sekita, T, Koda, J, Sekine, K, Udaka, J, Takeda, N, Nakamura, K et al. Two cases of laryngeal palsy caused by varicella-zoster virus. Pract Otol (Kyoto) 2003;96:717–21Google Scholar
16 Nishizaki, K, Onoda, K, Akagi, H, Yuen, K, Ogawa, T, Masuda, Y. Laryngeal zoster with unilateral laryngeal paralysis. ORL J Otorhinolaryngol Relat Spec 1997;59:235–7Google Scholar
17 Doi, H, Segawa, F, Koyano, S, Suzuki, Y, Kuroiwa, Y. A case of Vernet's syndrome due to varicella-zoster virus infection [in Japanese]. Rinsho Shinkeigaku Clin Neurol (Tokyo) 2001;41:695697Google Scholar
18 Kikuchi, H, Yoshimura, T, Hara, H, Mihara, F, Kobayashi, T. A case of multiple cranial neuropathy due to varicella-zoster virus infection. Detection of involvement of cranial ganglia with MRI [in Japanese]. Rinsho Shinkeigaku Clin Neurol (Tokyo) 1995;35:814–16Google ScholarPubMed
19 Parker, WJC. Multiple cranial nerve involvement with herpes zoster. Med J Aust 1971;2:1179–80Google Scholar
20 Aitken, RS, Brain, RT. Facial palsy and infection with zoster virus. Lancet 1933;i:1922Google Scholar
21 Muroi, M, Kamei, T, Yasuoka, Y, Ishii, H, Watanabe, K. Seven cases of cephalic herpes zoster with involvement of the lower cranial nerves [in Japanese]. J Jpn Bronchoesophagol Soc 1987;38:434–40Google Scholar
22 Aizawa, H, Ohtani, F, Furuta, Y, Sawa, H, Fukuda, S. Variable patterns of varicella-zoster virus reactivation in Ramsay Hunt syndrome. J Med Virol 2004;74:355–60CrossRefGoogle ScholarPubMed
23 Murakami, S, Honda, N, Mizobuchi, M, Nakashiro, Y, Hato, N, Gyo, K. Rapid diagnosis of varicella-zoster virus infection in acute facial palsy. Neurology 1998;51:1202–5CrossRefGoogle ScholarPubMed
24 Mackay, IM, Arden, KE, Nitsche, A. Real-time PCR in virology. Nucleic Acids Res 2002;30:1292–305Google Scholar
25 Furuta, Y, Ohtani, F, Sawa, H, Fukuda, S, Inuyama, Y. Quantitation of varicella-zoster virus DNA in patients with Ramsay Hunt syndrome and zoster sine herpete. J Clin Microbiol 2001;39:2856–9Google Scholar
26 Logemann, JA. Role of the modified barium swallow in management of patients with dysphagia. Otolaryngol Head Neck Surg 1997;116:335CrossRefGoogle ScholarPubMed
27 Murakami, S, Hato, N, Horiuchi, J, Honda, N, Gyo, K, Yanagihara, N. Treatment of Ramsay Hunt syndrome with acyclovir-prednisone: significance of early diagnosis and treatment. Ann Neurol 1997;41:353–7CrossRefGoogle ScholarPubMed
28 Furuta, Y, Ohtani, F, Masuda, Y, Fukuda, S, Inuyama, Y. Early diagnosis of zoster sine herpete and antiviral therapy for the treatment of facial palsy. Neurology 2000;55:708–10Google Scholar