Speech and Swallowing Impairments in Herpes Zoster: A Case Report

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Year : 2025 | Volume : 14 | Issue : 03 | Page :
    By

    Girish K S,

  • Shashank D,

  • Chandan V,

  1. Assistant Professor, Department of Speech Language Pathology (SLP), JSS Institute of Speech and Hearing (JSSISH), Dharwad, Karnataka, India
  2. Student, Department of Speech Language Pathology (SLP), JSS Institute of Speech and Hearing (JSSISH), Dharwad, Karnataka, India
  3. Student, Department of Speech Language Pathology (SLP), JSS Institute of Speech and Hearing (JSSISH), Dharwad, Karnataka, India

Abstract

Herpes zoster (HZ), caused by reactivation of varicella-zoster virus, can extend beyond dermatological manifestations to involve cranial nerves, resulting in complex speech and swallowing deficits. This case report presents a 54-year-old male with herpes zoster–related cranial neuropathy, who developed unilateral vocal fold paralysis, dysphonia, and dysphagia. Comprehensive assessment included perceptual, acoustic, endoscopic, and patient-reported outcome measures. Perceptual voice evaluation revealed severe dysphonia with breathiness, asthenia, strain, and reduced loudness, confirmed by high Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) scores and GRBAS ratings. Acoustic analysis showed elevated jitter (1.54%) and shimmer (8.64%), reduced harmonic-to-noise ratio (14.12), and shortened maximum phonation durations (2–3 seconds), indicating glottic insufficiency. The Voice Handicap Index (VHI) reflected moderate psychosocial burden. Swallowing assessments revealed severely reduced quality of life (SWAL-QOL = 109) and moderate dysphagia handicap (DHI = 49), highlighting nutritional and social challenges. Rigid laryngoscopy confirmed left vocal fold paralysis, pharyngeal wall ulceration, and herpes zoster lesions on the arytenoid. Fiberoptic Endoscopic Evaluation of Swallowing (FEES) revealed pooling in the pyriform fossa, consistent with vagal nerve dysfunction and impaired airway protection. Findings align with earlier reports of herpes zoster affecting multiple cranial nerves and emphasize its potential to disrupt phonatory, resonatory, and swallowing subsystems. This case underscores the importance of early, multidimensional assessment to document the functional consequences of HZ and to guide speech-language pathology interventions. Recognition of HZ as an etiology for cranial neuropathy is crucial for timely rehabilitation and improved quality of life.

Keywords: Herpes zoster, cranial neuropathy, vocal fold paralysis, dysphonia, dysphagia, speech-language pathology.

[This article belongs to Research and Reviews : A Journal of Medical Science and Technology ]

How to cite this article:
Girish K S, Shashank D, Chandan V. Speech and Swallowing Impairments in Herpes Zoster: A Case Report. Research and Reviews : A Journal of Medical Science and Technology. 2025; 14(03):-.
How to cite this URL:
Girish K S, Shashank D, Chandan V. Speech and Swallowing Impairments in Herpes Zoster: A Case Report. Research and Reviews : A Journal of Medical Science and Technology. 2025; 14(03):-. Available from: https://journals.stmjournals.com/rrjomst/article=2025/view=235243


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Regular Issue Subscription Original Research
Volume 14
Issue 03
Received 28/08/2025
Accepted 03/11/2025
Published 17/12/2025
Publication Time 111 Days
108

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