Postviral Vagal Neuropathy

Objectives: Postviral vagal neuropathy (PVVN) is a clinical diagnosis characterized by laryngeal complaints initiated by an upper respiratory tract infection (URI). Little is known about the natural history of this disease, and only small case series have been reported. We describe the clinical pres...

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Bibliographic Details
Published in:Annals of otology, rhinology & laryngology rhinology & laryngology, 2009-04, Vol.118 (4), p.247-252
Main Authors: Rees, Catherine J., Henderson, Arthur H., Belafsky, Peter C.
Format: Article
Language:English
Subjects:
Adult
Aged
Anti-Bacterial Agents - therapeutic use
Biological and medical sciences
Cough - etiology
Cross-Sectional Studies
Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes
Dysphonia - etiology
Female
Humans
Laryngoscopy
Male
Medical sciences
Middle Aged
Nervous system (semeiology, syndromes)
Neurology
Non tumoral diseases
Otorhinolaryngology. Stomatology
Patient Acceptance of Health Care - statistics & numerical data
Prospective Studies
Referral and Consultation
Respiratory Tract Infections - complications
Respiratory Tract Infections - drug therapy
Sick Leave
Surveys and Questionnaires
Time Factors
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
Vagus Nerve Diseases - virology
Vocal Cord Paralysis - virology
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Summary:Objectives: Postviral vagal neuropathy (PVVN) is a clinical diagnosis characterized by laryngeal complaints initiated by an upper respiratory tract infection (URI). Little is known about the natural history of this disease, and only small case series have been reported. We describe the clinical presentation, symptoms, patient demographics, and natural history of PVVN. Methods: A cross-sectional survey of all patients with a diagnosis of PVVN from January 1, 2006, to December 31, 2006, was prospectively administered, detailing disease onset, type and duration of symptoms, demographics, and previous treatment. The Reflux Symptom Index, Voice Handicap Index, and laryngoscopic findings were collected for each patient. Results: Forty-four patients with PVVN were identified. The mean age (±SD) was 48 ± 13 years, and 73% of the patients were female. The most common initial URI symptoms were cough (89%), nasal congestion (75%), and rhinorrhea (64%). Fifty-nine percent of the patients took antibiotics, and the mean time between symptom onset and presentation to the laryngologist was 83 ± 127 weeks. The most common persistent symptoms were cough (52%), throat clearing (48%), dysphonia (41.5%), and vocal fatigue (43%). Fifty-seven percent of the patients consulted 3 or more physicians for their symptoms. The mean Voice Handicap Index was 13.4 ± 10.3, and the mean Reflux Symptom Index was 17.7 ± 11. Fortynine percent of the patients had evidence of vocal fold paresis on strobovideolaryngoscopy. Conclusions: PVVN is a clinical entity characterized by a complex of laryngeal symptoms that begin after a URI. The symptoms include chronic cough, excessive throat clearing, dysphonia, and vocal fatigue. Affected individuals are typically in their fifth decade of life and appear more likely to be women. Most patients have seen multiple physicians, and the time to laryngologist referral is often delayed.
ISSN:0003-4894
1943-572X
DOI:10.1177/000348940911800402