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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: yonekawa@med.kurume-u.ac.jp

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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