Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We describe a case of unilateral IX, X and XI cranial and upper cervical nerve palsies involving zoster sine herpete (ZSH). A 63-year-old man experienced nausea, loss of appetite and general fatigue. On 4 days of illness, dysphagia, dysarthria and difficulty in elevation of his right arm appeared. Neurological examination showed the right curtain sign, a nasal voice and a decreased right gag reflex. He could hardly elevate his right arm laterally. Needle electromyography revealed positive sharp waves in his right trapezius muscle. Although no skin lesion was detected, anti-varicella-zoster virus antibodies were positive in both serum and cerebrospinal fluid. Acyclovir and a steroid were ineffective for these symptoms. Although case reports of unilateral IX, X and XI cranial nerve palsies with ZSH is very rare, ZSH should be kept in mind in the differential diagnosis of multiple cranial nerve palsies.
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PMID:[A case of zoster sine herpete with involvement of the unilateral IX, X and XI cranial and upper cervical nerves]. 1061 62

Herpetic gingivostomatitis (HGS) is the predominant manifestation of cutaneomucosal herpes in children with HSV1 primary infection before the age of 3 years. The infection is self limiting and lasts 10 to 14 days. Pain and dysphagia are particularly important during the first week of infection and may necessitate parenteral rehydratation and administration of antalgesics. HGS in the young child causes substantial morbidity leading to hospital and social costs (work stoppage for parents). The clinical course is generally benign with the exception of forms with important extension, eczema, herpeticum Kaposi-Juliusberg pustulosis observed at this age only in children with atopic dermititis. Other severe forms are observed in the neonate and immunodepressed subject, which can also be caused by HSV1. Forms with little or not clinical manifestation predominate and generally go undiagnosed, explaining the asymptomatic viral excretion observed in the saliva or other secretions (ocular, genital secretions). Despite the sterotypic nature of the clinical expression, HGS is still often undiagnosed both by general practitioners and pediatricians. This lack of diagnosis generally has few consequences due to the benign course in a few days, but the infection can have an important psychological and social leading to significant healthcare costs. Moderate and severe forms require medical care. Aciclovir should be prescribed if the diagnosis is made early (3 days) in combination with symptomatic care. Studies of the medical and economic impact of herpetic gingivostomatis should be conducted.
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PMID:[Herpes simplex in children. Clinical manifestations, diagnostic value of clinical signs, clinical course]. 1212 30

In March 2003, a 34-year-old man with left facial palsy, dysphagia, and hoarseness treated with acyclovir suffered worsened dermatological and neurological problems. A routine blood test in early April showed the patient to be HIV-antibody positive, so he was transferred to our hospital. Blood analysis showed serum HIV-RNA at 96,000 copies/mL and a CD 4 count of 170/microL. Brain MRI taken on admission showed a T 2 high lesion in their left medulla. Acyclovir was thought to be ineffective due to reduced cell-mediated immunity because of the HIV infection, and HAART therapy was begun. After two months of HAART, skin lesions and the T 2 high lesion in left medulla improred. HIV-RNA became undetectable and the CD 4 count exceeded 500/microL. Intracellular cytokine analysis by flow cytometry showed a shift from Th 2 to Th 1 dominance. The elimination of VZV may thus have been promoted by the combination of acyclovir and HAART.
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PMID:[Varicella-zoster virus symptoms and polyneuropathy in a patient with human immunodeficiency virus infection not improved until highly active anti-retroviral therapy added to acyclovir therapy]. 1651 24

Varicella zoster virus reactivation is a rare cause of pharyngeal dysphagia with long-term sequelae persisting in most cases. A 76-year-old immunocompetent woman presented with a 4-week history of dysphagia and dysphonia. Brain magnetic resonance imaging displayed a negative finding. Fiberoptic endoscopic evaluation of swallowing showed a severe dysphagia leading to a percutaneous gastrostomy eventually. Cerebrospinal fluid analysis revealed a lymphocytic pleocytosis and polymerase chain reaction amplified Varicella zoster virus DNA. Eight months after Acyclovir treatment and despite a persisting impairment of the recurrent laryngeal nerve, regular swallowing function was regained and percutaneous gastrostomy could be removed.
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PMID:Pharyngeal dysphagia due to Varicella zoster virus meningoradiculitis and full recovery: Case report and endoscopic findings. 2946 67