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Vernet syndrome by varicella-zoster virus.

Jo YR, Chung CW, Lee JS, Park HJ - Ann Rehabil Med (2013)

Bottom Line: He showed vesicular skin lesions on the left auricle.Antibody levels to varicella-zoster virus were elevated in the serum.Electrodiagnostic studies showed findings compatible with left spinal accessory neuropathy.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

ABSTRACT
Vernet syndrome involves the IX, X, and XI cranial nerves and is most often attributable to malignancy, aneurysm or skull base fracture. Although there have been several reports on Vernet's syndrome caused by fracture and inflammation, cases related to varicella-zoster virus are rare and have not yet been reported in South Korea. A 32-year-old man, who complained of left ear pain, hoarse voice and swallowing difficulty for 5 days, presented at the emergency room. He showed vesicular skin lesions on the left auricle. On neurologic examination, his uvula was deviated to the right side, and weakness was detected in his left shoulder. Left vocal cord palsy was noted on laryngoscopy. Antibody levels to varicella-zoster virus were elevated in the serum. Electrodiagnostic studies showed findings compatible with left spinal accessory neuropathy. Based on these findings, he was diagnosed with Vernet syndrome, involving left cranial nerves, attributable to varicella-zoster virus.

No MeSH data available.


Related in: MedlinePlus

Clinical photos of the left uvula and vocal cord in laryngoscopic view. (A) Asymmetric left vocal cord (arrow head) and ipsilateral arytenoid (arrow) movement, especially hypomobile abduction during respiration. (B) Mild deviation of the uvula to the right side (arrow).
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Figure 2: Clinical photos of the left uvula and vocal cord in laryngoscopic view. (A) Asymmetric left vocal cord (arrow head) and ipsilateral arytenoid (arrow) movement, especially hypomobile abduction during respiration. (B) Mild deviation of the uvula to the right side (arrow).

Mentions: 32-year-old man with left shoulder weakness was consulted to our department for an electrodiagnostic study. This patient had been admitted to the department of otolaryngology in our hospital due to sore throat, left earache, hoarseness, and swallowing difficulty, which developed three weeks before the study. On admission, vesicular rashes on the patient's left ear were detected (Fig. 1). Speech audiometry, the stapedial reflex test, tympanometry, the auditory brainstem response threshold test, and the pure tone test were all normal. Laryngoscopy showed that his left vocal cord was hypomobile (Fig. 2A). On neurological examination, he showed impaired gag reflex on the left side and deviation of the uvula to the right side (Fig. 2B). There was no impairment of facial sensation and motion, no tongue deviation or nystagmus. He had no particular underlying disease. Records revealed that twenty years ago, the patient had tympanoplasty in his left ear due to injury by trauma.


Vernet syndrome by varicella-zoster virus.

Jo YR, Chung CW, Lee JS, Park HJ - Ann Rehabil Med (2013)

Clinical photos of the left uvula and vocal cord in laryngoscopic view. (A) Asymmetric left vocal cord (arrow head) and ipsilateral arytenoid (arrow) movement, especially hypomobile abduction during respiration. (B) Mild deviation of the uvula to the right side (arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3713306&req=5

Figure 2: Clinical photos of the left uvula and vocal cord in laryngoscopic view. (A) Asymmetric left vocal cord (arrow head) and ipsilateral arytenoid (arrow) movement, especially hypomobile abduction during respiration. (B) Mild deviation of the uvula to the right side (arrow).
Mentions: 32-year-old man with left shoulder weakness was consulted to our department for an electrodiagnostic study. This patient had been admitted to the department of otolaryngology in our hospital due to sore throat, left earache, hoarseness, and swallowing difficulty, which developed three weeks before the study. On admission, vesicular rashes on the patient's left ear were detected (Fig. 1). Speech audiometry, the stapedial reflex test, tympanometry, the auditory brainstem response threshold test, and the pure tone test were all normal. Laryngoscopy showed that his left vocal cord was hypomobile (Fig. 2A). On neurological examination, he showed impaired gag reflex on the left side and deviation of the uvula to the right side (Fig. 2B). There was no impairment of facial sensation and motion, no tongue deviation or nystagmus. He had no particular underlying disease. Records revealed that twenty years ago, the patient had tympanoplasty in his left ear due to injury by trauma.

Bottom Line: He showed vesicular skin lesions on the left auricle.Antibody levels to varicella-zoster virus were elevated in the serum.Electrodiagnostic studies showed findings compatible with left spinal accessory neuropathy.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

ABSTRACT
Vernet syndrome involves the IX, X, and XI cranial nerves and is most often attributable to malignancy, aneurysm or skull base fracture. Although there have been several reports on Vernet's syndrome caused by fracture and inflammation, cases related to varicella-zoster virus are rare and have not yet been reported in South Korea. A 32-year-old man, who complained of left ear pain, hoarse voice and swallowing difficulty for 5 days, presented at the emergency room. He showed vesicular skin lesions on the left auricle. On neurologic examination, his uvula was deviated to the right side, and weakness was detected in his left shoulder. Left vocal cord palsy was noted on laryngoscopy. Antibody levels to varicella-zoster virus were elevated in the serum. Electrodiagnostic studies showed findings compatible with left spinal accessory neuropathy. Based on these findings, he was diagnosed with Vernet syndrome, involving left cranial nerves, attributable to varicella-zoster virus.

No MeSH data available.


Related in: MedlinePlus