J Neurocrit Care.  2018 Jun;11(1):43-46. 10.18700/jnc.180054.

Zoster Laryngitis with Multiple Cranial Nerve Palsy Progressed as Ascending Involvement

Affiliations
  • 1Department of Neurology, Daegu Fatima Hospital, Daegu, Korea.
  • 2Department of Neurology, Yeungnam University College of Medicine, Daegu, Korea. doctorjung86@gmail.com

Abstract

BACKGROUND
Herpes zoster of the head and neck commonly presents with Ramsay Hunt syndrome. However, vesicular eruptions may occur on the pharyngeal or laryngeal area with multiple lower cranial-nerve (CN) palsy. CASE REPORT: We report on the case of a 54-year-old man with herpes zoster of the pharynx and larynx with multiple CN palsy and persistent hiccups. He initially developed progressive dysphagia, hoarseness, and persistent hiccups (CN IX and X). After admission, Dizziness, hearing impairment, and peripheral facial palsy (CN VII and VIII) were complicated. The results of a polymerase chain reaction test of saliva and vesicular fluid from the ear and throat were strongly positive for varicella zoster virus. The progression of CN palsy was in an ascending sequence.
CONCLUSION
We suggest that the sequence of CN palsy may be either ascending or descending, depending on the initial site of involvement.

Keyword

Herpes zoster; Cranial nerve diseases; Laryngitis; Hiccup

MeSH Terms

Cranial Nerve Diseases*
Cranial Nerves*
Deglutition Disorders
Dizziness
Ear
Facial Paralysis
Head
Hearing Loss
Herpes Zoster Oticus
Herpes Zoster*
Herpesvirus 3, Human
Hiccup
Hoarseness
Humans
Laryngitis*
Larynx
Middle Aged
Neck
Paralysis
Pharynx
Polymerase Chain Reaction
Saliva
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