[Left vocal cord paralysis in cytomegalovirus multifocal neuropathy in a patient with HIV infection].

Cytomegalovirus multifocal neuropathies (CMV-MN) in patients with AIDS are much less frequent than meningoradiculitis. We report here the case of a patient with AIDS hospitalized because of severe motor weakness and paralyzed left true vocal cord (PVC), related to a multifocal neuropathy. CSF analysis was normal with a negative PCR for CMV, but neuromuscular biopsy showed typical CMV inclusions. The patient's condition improved with high dose foscarnet therapy, followed by a combination of ganciclovir plus foscarnet, during a five-month follow-up period. Twenty three case reports of CMV-MN have been published in the literature, only 2 of them presenting with a PVC. Extraneurological CMV involvement was usually documented. PCR for CMV in CSF was most often positive. However CMV inclusions were not frequently observed. The patients were usually improved under therapy with usually ganciclovir but relapse was observed in fifty percent within 3 to 6 months despite secondary prophylaxis.