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Korean J Neurogastroenterol Motil. 2005 Jun;11(1):80-84. Korean. Case Report.
Park HY , Lee OY , Yang SY , Cheon SM , Lee HL , Han DS , Jeon YC , Sohn JH , Yoon BC , Choi HS , Han JS , Lee MH , Lee DH , Kee CS , Cho SH .
Department of Internal Medicine, Hanyang University School of Medicine, Seoul, Korea. leeoy@hanyang.ac.kr
Department 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.

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