孤立的迷走神经麻痹可能与单纯疱疹病毒感染有关

Isolated vagus nerve palsy probably associated with herpes simplex virus infection

　

单纯疱疹病毒(HSV)感染引起的迷走神经麻痹是罕见的。

我们在此报告一位29岁男性患者，其右侧肌痛及喉痛的急性发作，接着是声音困难、吞咽困难及软腭深部的小泡。喉镜检查显示右侧声带麻痹。颈部至胸部CT未见局部病变。

3个月后，他的血清HSV IgG抗体效价升高8倍，经喉拭子培养进行病毒分离得到HSV i型，颈部MRI t2加权图像显示右侧声门下区域信号强度异常高，钆增强，与局部感染相符。

此后，一疗程给出了一疗程阿昔洛韦。在结束阿昔洛韦三个月后，他的症状几乎消失，颈部核磁共振成像没有显示上述病变。

应考虑HSV感染可作为特发性声嘶和吞咽困难的鉴别诊断。

　

Isolated vagus nerve palsy probably associated with herpes simplex virus infection

Vagus nerve palsy caused by herpes simplex virus (HSV) infection is rare. Here, we present a 29-year-old man with acute onset of right side otalgia and sore throat, followed by dysphonia, dysphagia and some vesicles seen on the deep soft palate. Laryngoscopy revealed right vocal cord palsy. Neck to chest CT did not reveal local lesion. Three months later, his serum HSV IgG antibody titer was eight times elevation and a throat swab culture for virus isolation yielded HSV type I. T2-weighted images of neck MRI showed abnormally high signal intensity on the right sub-glottis region with Gadolinium enhancement that was compatible with local infection. Thereafter, one course of acyclovir; was given. Three months after finishing the acyclovir, his symptoms were almost gone and neck MRI did not show the aforementioned lesions. HSV infection should be considered as a differential diagnosis for patients with idiopathic dysphonia and dysphagia.

Isolated vagus nerve palsy probably associated with herpes simplex virus infection | Request PDF. Available from: https://www.researchgate.net/publication/11796774_Isolated_vagus_nerve_palsy_probably_associated_with_herpes_simplex_virus_infection [accessed Oct 25 2018].