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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 ,
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
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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

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