Polyneuritis cranialis due to varicella-zoster virus in the absence of rash

Abstract

Recently, Gilden et al [1] reported two cases of zoster sine herpete. Zoster sine herpete is a varicella-zoster virus (VZV)-associated syndrome without the rash of cutaneous zoster. [2] In the few reported cases of lower cranial neuritis due to VZV, most of the patients also had seventh and eighth cranial nerve involvement and herpetic lesions. We report the first case of zoster sine herpete affecting only the unilateral ninth, tenth, and eleventh cranial nerves. A 43-year-old Japanese man who developed an upper respiratory infection followed by pharyngeal pain, dysphagia, and hoarseness was admitted to the hospital on March 30, 1994. On physical examination he was afebrile, with a pulse rate of 60 beats per minute and blood pressure of 112/62 mmHg. There was no evidence of skin rash within the regions of his ears, face, and oral cavity, …