Two Cases of Associated Laryngeal Paralysis Caused by Varicella-Zoster Virus (VZV) Reactivation

Abstract

We reported on two cases of associated laryngeal paralysis due to varicella-zoster virus (VZV) infection. One case, a 64-year-old woman, complained of headache, hoarseness and dysphasia. She had no skin rash. Physical examinations revealed paralyses of the right soft palate and right laryngeal region. The serum antibody (IgM) for VZV was markedly increased. She was diagnosed as having unilateral paralysis of the IX and X cranial nerves caused by VZV. She was treated with an intravenous steroid, but paralysis of the IX and X cranial nerves persisted.
The other case, a 58-year-old man, was admitted to our hospital complaining of otalgia on the right side, a rush on the right auricle, hoarseness, dysphasia and facial palsy on the right side. Herpetic vesicles were present on the right arytenoid. The serum antibody titer for VZV was elevated. He was diagnosed as having unilateral paralysis of the VII, IX and X cranial nerves caused by VZV. He was treated with an intravenous acyclovir and steroid. After treatment he did not have any residual signs of the disease.
In cases of unilateral cranial nerve palsy, herpes zoster should be considered.