Hoshino Chisho, Yamabe Akane
General Internal Medicine, Ohta-Nishinouchi Hospital, Koriyama City, Japan.
BMJ Case Rep. 2012 Jul 9;2012:bcr0120125538. doi: 10.1136/bcr.01.2012.5538.
The authors present a 90-year-old woman with unilateral glossopharyngeal, vagal and spinal accessory cranial nerve palsy along with pharyngeal and laryngeal vesicular eruptions. She was diagnosed with herpes zoster based on PCR testing on vesicular fluid for varicella-zoster virus (VZV). Reactivation of VZV in the head and neck region can cause life-threatening neurologic sequelae. Clinicians should be alert to the possibility of herpes zoster in a case of unilateral multiple cranial neuropathies and rapid combination therapy with acyclovir and corticosteroid should be initiated.
作者报告了一名90岁女性，患有单侧舌咽神经、迷走神经和副神经颅神经麻痹，同时伴有咽喉部水疱样皮疹。根据对水疱液进行水痘-带状疱疹病毒（VZV）的PCR检测，她被诊断为带状疱疹。VZV在头颈部区域的重新激活可导致危及生命的神经后遗症。对于单侧多发性颅神经病变的病例，临床医生应警惕带状疱疹的可能性，并应立即开始使用阿昔洛韦和皮质类固醇进行联合快速治疗。
