Document Detail

An Old Flame Reignites: Vagal Neuropathy Secondary to Neurosyphilis.
MedLine Citation:
PMID:  24315656     Owner:  NLM     Status:  Publisher    
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.
STUDY DESIGN: Case report.
METHODS: Review of medical records and literature search.
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'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.
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.
Travis A L Klein; Marion B Ridley
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-12-3
Journal Detail:
Title:  Journal of voice : official journal of the Voice Foundation     Volume:  -     ISSN:  1873-4588     ISO Abbreviation:  J Voice     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2013-12-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8712262     Medline TA:  J Voice     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.
Department of Otolaryngology-Head and Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida.
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