Abstract
Herpes zoster is an acute skin disease that presents after the reactivation of varicella zoster virus (VZV), characterized by clinical manifestations including meningoencephalitis, Guillain-Barré syndrome, vasculopathy, and cranial nerve involvement, such as Ramsay Hunt syndrome, trigeminal neuralgia, and pharyngolaryngeal involvement. We present the case of a 33-year-old man with unilateral pharyngeal and laryngeal paresis, otalgia, tinnitus, and vesicular rash along the external auditory canal of the left ear. Imaging studies, computed tomography (CT) and magnetic resonance imaging (MRI), revealed no pathology. The examination of the cerebrospinal fluid (CSF) revealed lymphocytic pleocytosis. Polymerase chain reaction of CSF was positive for VZV DNA. Based on the clinical picture and the results of the CSF examination, pharyngolaryngeal involvement was presumed. The patient was on combination therapy with antiviral medication and corticosteroid, which showed reversal of neurological symptomatology and reduction of rash.