多発性脳神経障害を呈した帯状疱疹症例 (三吉康郎教授開講20周年記念論文集)

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A case of a 59-year-old male with paralysis of the right Vth, VIIth, VIIIth, IXth and Xth cranial nerves is reported in this paper. The patient had complaints of ear and facial pain, peripheral facial palsy on the right side, right hearing impairment, vertigo and dysphagia. Herpetic vesicles were found in the cavum conchae and the area around the ear, eye and lips on the right side. On oral and pharyngolaryngeal examination the following pathological findings were revealed: paralysis of the soft palate on the right side, herpetic enanthema of the epiglottis, aryepiglottic fold and false cord on the right side with vocal cord palsy. On the examination of hearing and vestibular function, right sensorineural hearing loss and canal palsy were found. Lymphocytosis was shown on the cerebrospinal fluid examination. A significant rise in the antibody titer to herpes zoster virus and a moderate rise in those to herpes simplex and influenza A virus. These findings strongly indicated that herpes zoster infection affected the Vth, VIIth, VIIIth, IXth and Xth cranial nerves concurrently in this case. Six months after the first examination, disturbance of the Vth, VIIth and IXth cranial nerves abated completely and that of the Xth cranial nerve was alleviated to a certain extent by the administration of a massive amount of ATP. The disturbance of the VIIIth cranial nerve, however, did not respond to the treatment at all.
耳鼻咽喉科臨床学会の論文