Hostname: page-component-848d4c4894-4hhp2 Total loading time: 0 Render date: 2024-05-27T10:12:42.948Z Has data issue: false hasContentIssue false
  • English
  • Français

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 ,
H Umeno ,
S Hamakawa ,
T Nakashima  and
H Shoji
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: yonekawa@med.kurume-u.ac.jp
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

Herpes Virus 3, HumanLaryngeal NervesParalysisGlossopharyngeal Nerve DiseasesPhotofluorography
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 2 , February 2008 , pp. 170 - 176
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Hunt, JR. On herpetic inflammation of the geniculate ganglion. A new syndrome and its complications. J Nerv Ment Dis 1907;34:73–96CrossRefGoogle 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;9:89–91Google 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;62:638–652CrossRefGoogle 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;41:695–697Google 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:19–22Google 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