New wine in old bottles” : the Superior Laryngeal Nerve (NLS) neuralgia.

Frans Lecluse

In the general ENT praxis this pain syndrome (NLS) at one site of the neck at the level of the hyoid membrane is a well known problem. The pain could exist for weeks or months and is interfering with swallowing, speaking and singing. A manner of therapy are injections with local anaesthetics (lidocain, gabapentin) or the oral intake of carbemazepin. German phoniatricians (Pahn c.s) introduced already in 1974 special developed microwaves (Radarmed, Robert Bosch, Berlin) as an external therapy in NLS with a rather good result. In the latest years laboratories have heavily improved their techniques (ELISA) in the estimation of antibodies of viral infections like antibodies against herpes simplex virus.
In more than 200 cases of NLS the titer of herpes simplex antibodies (IgG and IgM) was determined. In Europe about 70% of the population is carrier of herpes simplex IgG antibodes. In NLS 95 % of the cases showed a correlation with a high positive IgG titer of herpes simplex virus, the so called sleeping titer.
In the therapy with the medical microwave a phenomenon will be discussed referring to heath shock, generally used in cell biologic experiments.
The idea of a viral genesis in NLS and the different therapies could modify the strategy in this pain syndrome. In resistant cases antiviral therapy could be an option.

F.L.E. Lecluse, MD PhD.
Ubbo- Emmius- Klinik- Norden Germany
26506 Norden, Germany