A case of amyotrophic lateral sclerosis with bilateral vocal cord paralysis necessitating tracheotomy
| Autor: | Motomi Arai, Yuki Yagi, Goro Oshima, Shiori Endo |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Cord Movement disorders medicine.diagnostic_test business.industry Amyotrophic Lateral Sclerosis Laryngoscopy Bilateral vocal cord paralysis medicine.disease Sudden death Surgery Anesthesia medicine Humans Neurology (clinical) Vocal cord paralysis Tracheotomy medicine.symptom Amyotrophic lateral sclerosis Vocal cord paresis business Vocal Cord Paralysis Aged |
| Zdroj: | Rinsho Shinkeigaku. 51:765-769 |
| ISSN: | 1882-0654 0009-918X |
| DOI: | 10.5692/clinicalneurol.51.765 |
| Popis: | Vocal cord movement disorders are increasingly recognized in patients with amyotrophic lateral sclerosis (ALS). We describe a patient with limb-onset ALS who developed vocal cord paralysis. A 74-year-old Japanese male consulted our clinic with a 6-month history of weakness in both arms. His family history was unremarkable. There were fasciculations and mild atrophy of the tongue and both arms. In the legs, muscle strength was almost normal but widespread fasciculations were present. All tendon reflexes were hypoactive and pathological reflexes were absent. Thereafter, he developed weakness of the legs and showed increased eating time. Babinski sign was positive bilaterally at this stage. The forced vital capacity dropped from 90% at the initial evaluation to 62% of the predicted value 14 months later. Two years after disease onset, the patient developed aspiration pneumonia with hoarseness and had difficulty clearing his throat of phlegm. Laryngoscopy demonstrated severe vocal cord paresis on both sides, particularly in the abductor muscles possibly leading to obstruction. Tracheotomy was performed because of the risk that the patient could choke to death. A review of the literature suggests that severe impairment of vocal cord abduction could be a prelude to sudden death in ALS. Follow up by laryngoscopic examination is necessary. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|