[Herpes zoster of the right cervical region associated with right facial nerve palsy and hoarseness].
A 69-year-old man was suffering from herpes zoster on his 2nd and 3rd right cervical spinal segments and 3rd branch of the trigeminal nerve. He came to our hospital on his 10th illness day and was treated with continuous cervical epidural block, intravenous infusion of acyclovir for five days, and oral paramethasone and Vitamin B12. Oh his 18th illness day, right facial nerve palsy and hoarseness became clear. His cerebrospinal fluid showed no abnormality except cell count 23 x 3 mm-2. No clear paralysis of vocal cords was detected on laryngoscopy. He was also treated with right stellate ganglion block starting on his 21st illness day. His pain and facial nerve palsy recovered completely by his 68th illness day, but hoarseness continued about two months. The hoarseness might be a result of spread of the disease 1) by cerebrospinal fluid, 2) by contact with the 3rd cervical nerve and vagal nerve via accessory nerve, and 3) direct effect on the vocal cords and the muscles controlling them. Herpes zoster on the head and neck region shows various complications and we should follow its course cautiously.
Dehara
K
K
Department of Anesthesiology, Showa University Fujigaoka Hospital, Yokohama.
Takeda
S
S
Nakamizo
N
N
Morimoto
F
F
Ikeda
T
T
Tomaru
T
T
D000368:Aged; D002574:Cervical Vertebrae; D005158:Facial Paralysis / Q000150:complications*; D006562:Herpes Zoster / Q000150:complications*; D006685:Hoarseness / Q000150:complications*; D006801:Humans; D008297:Male