A case of herpes zoster affecting the glossopharyngeal nerve

Abstract

not eat because of a sore throat, which was confined to the right side of pharynx. She also complained of absence of taste on the right side of the tongue and of absence of sweet taste on the left side of the tongue. Small vesicles were seen on the right portion of the soft palate and the right palatine tonsil (Fig. 1). No other cranial nerve seemed to be affected.Complement-fixing (CF) antibody titers for varicellazoster were 1 : 32 (the normal range is less than 4 times), and varicella-zoster virus IgG (VZVIgG) titers on enzyme immunoassay were 103.2 (the normal range is less than 2.0). Using the PCR technique, we then found pieces of DNA specific for varicella-zoster virus in specimens from the vesicle and peripheral blood samples (Fig. 2). We diagnosed her as suffering from herpes zoster. She was admitted the day following the definitive diagnosis.After admission, the patient was given acyclovir 800 mg five times per day orally for 5 days and loxoprofen sodium 180 mg three times per day orally for 14 days. A stellate ganglion block with 5 ml of 1% mepivacaine was also performed for 28 days. The patient could eat liquid food three days after admission. CF antibody titers and VZVIgG titers decreased over several days. The vesicles became crusted 7 days after the commencement of treatment. The pain in the right ear and the sore throat were relieved within 1 month. Taste recovered completely on the left side of the tongue within 1 month, but absence of taste on the right side of the tongue has persisted. DiscussionThe patient complained of stabbing pain in the right ear. The glossopharyngeal nerve innervates the soft palate, the palatine tonsil, and the pharynx. It also detects taste from the posterior third of the tongue. The patient complained of loss of taste on the whole right

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

“…Many patients experience hearing loss and vestibulo-cochlear symptoms such as tinnitus and vertigo [418, 420, 425, 426]. The seventh and eighth cranial nerves are most commonly affected [420, 427], but many atypical cranial neuropathies have also been identified [428–431]; Ramsay Hunt syndrome has been associated with dysphonia [46, 424, 429, 432, 433], laryngitis [434, 435], loss of taste [436], chronic cough [437], hiccups [435, 438], dysphagia [46, 424, 429, 439], and persistent vomiting [438]. Other rare complications include jugular foramen syndrome [440] and non-facial neuromotor deficits [441].…”

Glossopharyngeal Postherpetic Neuralgia Palliated With Fluoroscopic‐Guided Nerve Block: A Case Report

“…Glossopharyngeal neuralgia causes unilateral pain affecting the ear, tongue, tonsillar fossa, and/or beneath the mandibular angle . Varicella zoster is an uncommon cause of glossopharyngeal neuralgia . Use of local anesthetics in the diagnosis and treatment of glossopharyngeal neuralgia dates back to at least the early 1980s, when cocaine applied to the tonsillar fossa was used in the diagnosis of glossopharyngeal neuralgia .…”

“…1,2 Varicella zoster is an uncommon cause of glossopharyngeal neuralgia. 3,4 Use of local anesthetics in the diagnosis and treatment of glossopharyngeal neuralgia dates back to at least the early 1980s, when cocaine applied to the tonsillar fossa was used in the diagnosis of glossopharyngeal neuralgia. 5 However, this may be the first documented case of glossopharyngeal postherpetic neuralgia treated with GNBs.…”