An Old Flame Reignites: Vagal Neuropathy Secondary to Neurosyphilis

作者：Klein Travis A L; Ridley Marion B^*

来源：Journal of Voice, 2014, 28(2): 255-257.

DOI：10.1016/j.jvoice.2013.08.018

• Neurosyphilis
• Vocal fold paresis
• Vagal neuropathy
• Velopharyngeal incompetence

Objective. This report describes neurosyphilis presenting as vocal fold paresis and velopharyngeal incompetence. This represents the first reported case of neurosyphilis presenting as a vagal neuropathy since 1963. %26lt;br%26gt;Study Design. Case report. %26lt;br%26gt;Methods. Review of medical records and literature search. %26lt;br%26gt;Results. The patient presented with voice changes and nasopharyngeal reflux of liquids. Examination showed a left vocal fold paresis and moderate velopharyngeal incompetence. Laryngeal electromyography revealed evidence of denervation, and neurologic evaluation showed bilateral Adie%26apos;s pupils and a positive CSF VDRL. A remote history of syphilis treated with one intramuscular injection was obtained. The patient was treated with 6 weeks of penicillin and regained normal vocal function with minimal residual intermittent hypernasality. %26lt;br%26gt;Conclusions. Given the recent increase in the incidence of syphilis in the United States, this case serves as a reminder of the importance of including syphilis in the differential diagnosis of cranial neuropathies and the increasing likelihood of syphilis presenting to otolaryngology and speech pathology practices. Syphilis, a disease whose incidence had declined progressively for 60 years in the United States, is now resurgent and must be considered in the evaluation of patients presenting with unexplained cranial neuropathies.

• 出版日期2014-3