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Development of an IFN-γ ELISpot Assay to Assess Varicella-Zoster Virus-specific Cell-mediated Immunity Following Umbilical Cord Blood Transplantation
Published on: July 9, 2014
Pharyngolaryngeal involvement by varicella-zoster virus
Lluís Nisa1, Basile Nicolas Landis, Roland Giger
1Department of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland. llnisa@yahoo.ca
Summary
Varicella-zoster virus (VZV) rarely affects cranial nerves IX and X, often alongside other cranial nerves. Full recovery from VZV pharyngolaryngeal involvement is uncommon, with persistent speech and swallowing issues common.
Area of Science:
- Neurology
- Infectious Diseases
- Otolaryngology
Background:
- Varicella-zoster virus (VZV) commonly affects cranial nerves V, VII, and VIII.
- Involvement of cranial nerves IX and X by VZV is rare and poorly understood.
Observation:
- A systematic review identified 54 cases of VZV pharyngolaryngeal involvement.
- Key symptoms included odynodysphagia and dysphonia, indicative of hemipharyngolaryngeal palsy.
- Vesicles were present in 66% of patients, and 48% had concurrent cranial nerve involvement, frequently affecting nerves VII and VIII.
Findings:
- Imaging studies were consistently normal.
- Virological tests were performed in 63% of cases.
- Seventy-two percent of patients received antiviral agents and/or corticosteroids, yet only 26% fully recovered.
Implications:
- VZV pharyngolaryngeal involvement is rare and usually part of a broader cranial polyneuropathy.
- Full recovery is infrequent, with many patients experiencing long-term sequelae, particularly in speech and swallowing.
- Close patient monitoring and follow-up are crucial due to the potential for persistent deficits.
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