Vocal cord paresis in acute ischemic stroke.
We prospectively determined the frequency of vocal cord paresis (VCP) among first-ever acute ischemic stroke patients. Vocal cords were examined endoscopically within 48 h of stroke onset, at 1 week and 1 month. Of the 54 study patients, 64.8% had lacunar (group 1), 22.2% cortical/large subcortical (group 2), 9.3% lateral medulla (group 3) and 3.7% other brainstem (group 4) infarcts. VCP was found in 11 (20.4%): 11.4% of group 1, 16.4% of group 2, 100% of group 3 and 0% of group 4. VCP was contralateral to the brain lesion in groups 1 and 2, and ipsilateral in 80% of group 3. VCP was strongly correlated with dysphonia (p < 0.0001) and resolved in 2/11 patients after 1 week and in 5/11 after 1 month. Our finding of VCP among acute ischemic stroke patients questions the belief that the nucleus ambiguous is invariably bilaterally innervated by supranuclear centers.
Venketasubramanian
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N
Department of Neurology, Tan Tock Seng Hospital, Singapore, Singapore. ramani_nv@notes.ttsh.gov.sg
Seshadri
R
R
Chee
N
N
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012846:Singapore / Q000453:epidemiology; D014826:Vocal Cord Paralysis / Q000453:epidemiology / Q000209:etiology*