Epstein-Barr Virus Infection associated with Acute Recurrent Laryngeal Nerve Palsy

Introduction: Epstein-Barr virus (EBV) belongs to the group of human herpes viruses and can cause the clinical syndrome of infectious mononucleosis. EBV infection has been reported to cause several neurological complications. However, cranial nerve deficits are rare and have been infrequently reported. To our knowledge, recurrent laryngeal nerve palsy in EBV acutely infected patients has been reported only once with a case of bilateral laryngeal nerve palsy. Case presentation: A case of a 41-year-old female Caucasian patient with a positive serology of active EBV infection developing acute recurrent laryngeal nerve palsy is presented. Fiberoptic rhinolaryngoscopy with stroboscopy showed complete paralysis of the left vocal cord in abduction with abundant secretions, consistent with unilateral recurrent laryngeal nerve paralysis. Full recovery over a 6-month follow-up period has been achieved by starting immediate speech therapy. Conclusion: Our case report confirms the possible involvement of EBV infection in recurrent laryngeal nerve palsy. This rarely described association should be taken into account as an extremely rare differential diagnosis in patients suffering from recurrent laryngeal nerve paralysis and fatigue symptoms with muscle pain. To minimize the risk of permanent palsy, immediate speech therapy is recommended.