Severe dysphagia caused by vagus nerve herpetic neuropathy: a case report

In this study, we report a rare case of herpetic infection of the larynx with vagus nerve palsy. Herpes simplex virus (HSV) and varicella zoster virus (VZV) are among the most common viral causes of vagus nerve (VN) dysfunction. The clinical presentation of herpetic laryngitis is variable. The diagnosis is clinical and can be confirmed by serological test or better yet by a PCR. When HSV or VZV infection is suspected, it is mandatory to start the antiviral treatment rapidly, within 72 hours. The use of corticosteroids remains a controversial subject. The consequences of vagus nerve damage are not negligible in terms of quality of life and may cause multiple symptoms due to the anatomical distribution of the nerve. Once the diagnosis is confirmed, intensive voice and swallowing rehabilitation must be undertaken to limit the functional impact and quality of life degradation.