Keywords
Vocal cord paralysis
Late stage Parkinson’s disease
Upper airway obstruction
Categories
How to Cite
Abstract
Introduction: Vocal cord paralysis often causes mortality by upper airway obstruction in some neurodegenerative diseases such as Parkinson’s disease and multiple system atrophy. Vocal cord paralysis is uncommon in Parkinson’s disease (PD) on the contrary it is more common in multiple system atrophy (MSA). The pathogenesis of vocal cord paralysis in Parkinson’s disease is not well understood but may involve degeneration of the nucleus ambiguous. In terms of managing patients with bilateral vocal cord paralysis in PD, it can either perform a tracheostomy to relieve the upper airway obstruction or optimize the medical treatment. There are very few available reported cases whereby patients are treated with medical treatment alone.
Case Report: We report a case of 65 years old lady who presented with stridor resulting from bilateral vocal cord paralysis and has been diagnosed with Parkinson’s disease for more than 10 years. She had her antiparkinson medication optimized and requiring no surgical intervention to relieve the upper airway obstruction.
Conclusion: In conclusion, we would like to emphasize that it is important to recognize bilateral vocal cord paralysis in Parkinson’s disease and early optimization of medical treatment could avoid a need for tracheostomy.
References
Muangpaisan W, Mathews A; Hori H, Seidel D. A systemic Review of the Worldwide prevalence and incidence of Parkinson’s disease. J Med Assoc Thai. 2011 Jun; 94(6):749-55. [Accessed 28 June 2021]. Available from : https://www.thaiscience.info/journals/Article/JMAT/10817133.pdf
Lieberman A. Parkinson’s disease: A Clinical Review. Am J Med Sci.1974 Feb;267(2):66-80. [Accessed 28 June 2021]. Available from: https://insights.ovid.com/american-medical-sciences/ajmeds/1974/02/000/parkinson-disease/1/00000441
Tsai CC, Wu MN, Liou LM, Chang YP. Levadopa reverse stridor and prevent subsequent endotracheal intubation in Parkinson disease patients with bilateral vocal cord palsy : A case report. Medicine (Baltimore). 2016 Dec; 95(50):e5559. https://doi.org/10.1097/md.0000000000005559
Plasse HM, Lieberman AN. Bilateral vocal cord paralysis in Parkinson’s disease. Arch Otolaryngol. 1981 Apr; 107(4):252-3. https://doi.org/10.1001/archotol.1981.00790400054013
Isozaki E, Naito R, Kanda T, Mizutani T, Hirai S. Different mechanism of vocal cord paralysis between spinocerebellar ataxia and multiple system atrophy. J Neurol Sci. 2002 May 15;197(1-2):37-43. https://doi.org/10.1016/s0022-510x(02)00046-1
Huppler EG, Schmidt HW, Devine D, Gage RP. Causes of vocal cord paralysis. Proc Staff Meet Mayo Clin. 1955 Nov 2;30(22):518–21.
Holinger LD, Holinger PC, Holinger PH. Etiology of bilateral vocal cord paralysis: a review of 389 cases. Ann Otol Rhinol Laryngol. Jul-Aug 1976;85(4 Pt 1) :428–36. https://doi.org/10.1177/000348947608500402
Blumin JH, Berke GS. Bilateral vocal fold paresis and multiple system atrophy. Arch Otolaryngol Head Neck Surg. 2002 Dec;128(12):1404–7. https://doi.org/10.1001/archotol.128.12.1404
Vas CJ, Parsonage M, Lord OC. Parkinsonism associated with laryngeal spasm. J Neurol Neurosurg Psychiatry. 1965 Oct;28(5):401–3. https://dx.doi.org/10.1136%2Fjnnp.28.5.401
Read D, Young A. Stridor and parkinsonism. Postgrad Med J. 1983 Aug ;59(694):520–1. https://doi.org/10.1136/pgmj.59.694.520
Corbin DO, Williams AC. Stridor during dystonic phases of Parkinson’s disease. J Neurol Neurosurg Psychiatry. 1987 Jun;50(6):821–2. https://doi.org/10.1136/jnnp.50.6.821
Lew MF, Shindo M, Moskowitz CB, Wilhelmsen KC, Fahn S, Waters CH. Adductor laryngeal breathing dystonia in a patient with lubag (X-linked dystonia-Parkinsonism syndrome). Mov Disord. 1994;9:318–20. https://doi.org/10.1002/mds.870090307
Nakane S, Motomura M, Furuya T, Shirabe S, Nakamura T. [A case of juvenile Parkinson disease with vocal cord abductor paralysis in the course of malignant syndrome]. Rinsho Shinkeigaku. Feb-Mar 1999;39(2-3):370–2.
Onoue H, Yukitake M, Kurohara K, Takasima H, Kuroda Y. [ A case report of Parkinson’s disease presenting with recurrent dyspneic attacks due to focal laryngeal dystonia]. Rinsho Shinkeigaku. 2003;43(4):192–4.
Qayyum A, Mierzwa K, See M, Sharma A, Montgommery PQ. Laser arytenoidectomy for bilateral vocal fold palsy in Parkinson’s disease. J Laryngol Otol. 2005 Oct;119:831–3. https://doi.org/10.1258/002221505774481345
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2018 Sharir Asrul Bin Asnawi et al.
