最近経験した喉頭混合麻ひの一症例

Abstract

Secondary vocal cord paralysis, so called “Vernet's syndrome” developed after an upper respiratory infection in a 33-year-old female who had complained of dys-phagia and hoarseness. Right soft palate paralysis, right vocal cord paralysis, paralysis of the right ternocleidomastoid and trapezius muscles, and difficulty in raising her right hand commenced 5 days after pharyngitis.Physical and X-ray examination revealed paralysis of the right IXth, Xth, and XIth cranial nerves and C5 spinal nerve. Primary or secondary invasion by tumors in the Jugular foramen and other neurological diseases were ruled out. The following pathological findings showed that this was a case of polyneuritis cranialis due to viral infection. High antibody titers to Herpes Zoster virus, Parainfluenza virus and Cytomegalo virus, a moderate rise in adenovirus antibodies, and an increase of lym-phocytes and protein in the spinal fluid. Herpes Zoster virus in the glossopharyn.gealvagal ganglia was thought to cause the paralysis.Two months after the first examination, the abnormarities of the IXth, Xth, and XIth cranial nerves had been alleviated to a certain extent by treatment with ATP and cortico steroid.