水痘帯状疱疹ウイルスが関与したと考えられる両側迷走神経麻痺例

A case of bilateral vagus nerve paralysis due to varicella zoster virus（VZV）

はじめに

　水痘帯状疱疹ウイルス（varicella zoster virus：VZV）の多くは小児期に初感染したのちに全身の神経節に潜伏感染する。その後，宿主の肉体的・精神的ストレスや免疫能低下によって再活性化し，皮膚・粘膜の症状，運動や知覚神経の麻痺を生じる。VZVが咽喉頭領域にのみ症状をきたすことは稀である。今回われわれは，VZVが関与したと考えられる両側迷走神経麻痺の1例を経験したので報告する。

　Bilateral vagus nerve paralysis due to varicella zoster virus（VZV）is extremely rare. A 69-year-old man presented with bilateral vagus nerve paralysis due to VZV. He had been treated with radiation therapy for laryngeal cancer 13 years ago. He complained of dyspnea secondary to upper respiratory tract inflammation. Although bilateral vocal cords paralysis was observed, no other abnormalities in head and neck region were found. Laboratory testing revealed elevated VZV IgM. He was administered with intravenous acyclovir and steroids. When vocal cord paralysis occurs, the possibility of VZV involvement should be considered depending on the patient's symptoms and clinical course.