Four Cases of Multiple Cranial Nerve Involvement with Varicella‐Zoster Virus

Abstract

Objectives: We report 4 cases of unilateral paralysis of the 7th, 8th, 9th, and 10th cranial nerves caused by varicella-zoster virus. Methods: Retrospective study with 4 cases from May 2008 to May 2012.The patients were 58, 69, 72, and78 years old. There were 2 male patients and 2 female patients. Results: Every case confirmed 9th or 10th cranial nerve paralysis preceding 7th or 8th cranial nerve paralysis. Every case was treated by antiviral medicine and high-dose prednisolone. Conclusions: There are various theories of the mechanisms involved in the spread of cranial nerve palsy. Our cases confirmed only 7th, 8th, 9th, or 10th cranial nerve paralysis. If cranial neuropathy spread via cerebrospinal fluid, lymph nodes, or by blood, other cranial nerves may be paralyzed. If cranial neuropathy spread by revitalization of every nerve ganglion, we cannot explain these systematic conditions. We discussed the spreading mechanisms of cranial neuropathy via intervention nerve ( for example, tympanic nerve, less petrosal nerve).