Korean J Neurogastroenterol Motil.  2005 Jun;11(1):80-84.

Dysphagia due to Glossopharyngeal and Vagus Nerve Palsy after Upper Respiratory Infection

Affiliations
  • 1Department of Internal Medicine, Hanyang University School of Medicine, Seoul, Korea. leeoy@hanyang.ac.kr
  • 2Department of Otorhinolaryngology, Hanyang University School of Medicine, Seoul, Korea.

Abstract

Oropharyngeal dysphagia is characterized by difficulty in transferring food from the mouth through the upper esophageal sphincter into the upper esophagus. Lesions involving the vagus and glossopharyngeal nerve may cause dysphagia and dysphonia. On rare ocassions, upper respiratory infection due to virus may affect the lower cranial nerves. We experienced a 76-year-old man who suffered with an upper respiratory infection, and this was followed by his dysphagia and dysphonia. The esophagogastroscopy was normal and the esophageal manometry revealed a lack of coordination between the pharyngeal constriction and the relaxation of upper esophageal sphincter, and there was a loss of the pharyngeal peak. Barium esophagography showed aspiration of the barium into the bronchus. Laryngoscopy revealed left vocal cord palsy and right deviation of the uvula. Neck CT and brain MRI did not reveal any local lesion. Because the serum varicella-zoster virus (VZV) IgM antibody titer was slightly increased, we gave him one cycle of acyclovir and prednisolone with swallowing training; two months later, his symptoms were improved. In conclusion, viral infection of the cranial nerves should be considered as part of the differential diagnosis for patients with dysphagia and dysphonia after an upper respiratory infection.

Keyword

Dysphagia; URI; Vocal cord palsy; Vagus nerve; Glossopharyngeal nerve

MeSH Terms

Acyclovir
Aged
Ataxia
Barium
Brain
Bronchi
Constriction
Cranial Nerves
Deglutition
Deglutition Disorders*
Diagnosis, Differential
Dysphonia
Esophageal Sphincter, Upper
Esophagus
Glossopharyngeal Nerve
Herpesvirus 3, Human
Humans
Immunoglobulin M
Laryngoscopy
Magnetic Resonance Imaging
Manometry
Mouth
Neck
Paralysis*
Prednisolone
Relaxation
Uvula
Vagus Nerve*
Vocal Cord Paralysis
Acyclovir
Barium
Immunoglobulin M
Prednisolone
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