Korean Journal of Critical Care Medicine  2015;30(2):123-127

doi:10.4266/kjccm.2015.30.2.123

Multiple System Atrophy Manifested by Bilateral Vocal Cord Palsy as an Initial Sign.

Yuri SEO ; Soomin JEUNG ; Heeyoung YOON ; Min Chul KIM ; Nah Kyum LEE ; Byeong Zu GHANG ; Sun Ju CHUNG ; Younsuck KOH

Keywords

airway obstruction; multiple system atrophy; parkinsonism; vocal cord paralysis

Country

Republic of Korea

Language

English

Abstract

A 71-year-old male initially presented with vocal cord palsy and underwent tracheostomy. After thorough examination, urogenital dysfunction, orthostatic hypotension, and Parkinsonism were found, which led to the diagnosis of multiple system atrophy (MSA). After the tracheostomy, bi-level positive airway pressure ventilation was required during the night due to nocturnal hypoxemia. Night-time hypoxemia is related to central sleep apnea, which is one of the manifestations of MSA. This is the first case of MSA manifested by bilateral vocal cord palsy as an initial sign in Korea. This case supports the notion that MSA should be taken into consideration when vocal cord paralysis is observed.