水痘帯状疱疹ウイルスによる混合性喉頭麻痺（Schmidt症候群）を呈した1例

A case of mixed laryngeal paralysis caused by the varicella-zoster virus

はじめに

　Schmidt症候群は，1892年にAdolf Schmidtによって報告された核性，または核下性に迷走神経，副神経が障害された混合性喉頭麻痺に名付けられた症候群である^1,2）。今回われわれは，嗄声，嚥下困難，肩挙上困難を主訴に受診した，水痘・帯状疱疹ウイルス（varicella-zoster virus：VZV）の再活性化により迷走・副神経障害を呈した混合性喉頭麻痺（Schmidt症候群）を経験したので，文献的考察を加え報告する。

　We encountered a case of mixed laryngeal paralysis（Schmidt's syndrome）with vagal and accessory neuropathy due to the reactivation of the varicella-zoster virus（VZV）. A 59-year-old man visited our hospital with chief complaints of hoarseness, sore throat, dyspnea, swallowing difficulty, and difficulty lifting the left shoulder. Laryngeal fiberscopy revealed a laryngeal mucosal rash, vocal cord paralysis, and soft palate paralysis. Based on serological tests, we speculated that the neuropathy was caused by the reactivation of VZV in the vagus ganglion. Lower cranial neuropathy（Ⅹ, Ⅺ）was thought to be caused by the VZV, which propagates through nerve anastomoses and causes multiple symptoms.