Simultaneous vocal fold and tongue paresis secondary to Epstein-Barr virusinfection

Dysphonia is a common presenting symptom in cases referred for otolaryngolo gic evaluation. Similarly, primary care physicians frequently see adolescen ts or young adults with symptomatic Epstein-Barr virus infection. Some of t he patients with active Epstein-Barr virus infection who have severe clinic al manifestations of infectious mononucleosis will be referred for otolaryn gologic evaluation. Voice abnormalities in these patients, though, are usua lly limited to altered resonance due to pharyngeal crowding by hyperplastic lymphoid tissue. We describe a patient with infectious mononucleosis who w as referred for evaluation of dysphonia and was diagnosed with unilateral t ongue and vocal fold paresis. We also discuss the patient's clinical course and review the related literature. Although uncommon, cranial nerve palsie s must be considered in the patient with Epstein-Barr virus infection who p resents with voice or speech disturbance.