Nine Cases of Laryngeal Paralysis Caused by Varicella-zoster Virus Reactivation

Varicella-zoster virus (VZV) reactivation is known to rarely cause inferior cranial nerve paralysis. We report our experience with nine cases. The symptoms of the nine patients included rash (n=4), pharyngeal pain (n=5), hoarseness (n=6), and all cases experienced dysphagia. Vagal (X) and glossopharyngeal (Ⅸ) nerve paralysis were observed in all cases, followed by facial (Ⅶ) nerve paralysis in six cases, vestibulocochlear (Ⅷ) nerve paralysis in seven cases, and accessory nerve paralysis in four cases. The diagnoses were confirmed by a serological analysis, cerebrospinal fluid analysis, or based on clinical findings. All patients were treated with a combination of acyclovir and intravenous steroids, and most achieved complete relief from laryngeal paralysis after varying periods of time.