Maeda A, Shiojiri T, Tsuchiya K, Watabiki S
Department of Neurology, Musashino Red Cross Hospital.
Rinsho Shinkeigaku. 1992 May;32(5):524-6.
A case of multiple cranial nerve palsy by herpes zoster was reported. A 79-year-old man showed fever, sore throat, and dysphagia. No vesicle was noted at ear and pharynx. The patient developed, later, left peripheral facial nerve palsy. The cerebrospinal fluid revealed pleocytosis with increased protein. The viral antibody titer of herpes zoster was significantly elevated both in cerebrospinal fluid and in serum. The left facial palsy was slightly improved. But his dysphagia didn't improve during at least 10 months after the onset. Among the cranial nerves, trigeminal and facial nerves are the most commonly affected by herpes zoster. But there are a few cases of the 9th and 10th cranial nerve involvement in the literature. However, dysphagia has rarely been reported in these previous cases, only four cases developed severe dysphagia like the present patient. All of these cases including our case were over sixty years old, while cases with slight dysphagia were under sixty years old. No other differentiating factor is noted between these two groups with regard to sites of vesicles, findings of cerebrospinal fluid and mode of therapy.
报告了1例带状疱疹所致多发性颅神经麻痹病例。一名79岁男性出现发热、咽痛和吞咽困难。耳部和咽部未见水疱。该患者后来出现左侧周围性面神经麻痹。脑脊液显示细胞增多且蛋白增加。脑脊液和血清中带状疱疹病毒抗体滴度均显著升高。左侧面神经麻痹稍有改善。但发病后至少10个月内其吞咽困难未见改善。在颅神经中，三叉神经和面神经最常受带状疱疹影响。但文献中仅有少数第9和第10颅神经受累的病例。然而，这些既往病例中很少有吞咽困难的报道，仅有4例像本患者一样出现严重吞咽困难。包括我们的病例在内，所有这些病例均超过60岁，而有轻微吞咽困难的病例年龄在60岁以下。在水疱部位、脑脊液检查结果及治疗方式方面，这两组病例之间未发现其他鉴别因素。
