title: Bilateral vocal fold paresis and multiple system atrophy.
abstract: OBJECTIVE
  To review a case series of patients with systemic neurodegenerative disease presenting to a laryngologist for workup of dysphonia and found to have bilateral vocal fold paresis.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Tertiary care voice center.
  
  
  METHODS
  Series of patients with neurodegenerative disorders examined for dysphonia.
  
  
  METHODS
  History and physical examination including fiberoptic laryngoscopy were performed on all patients. Some patients underwent polysomnography.
  
  
  RESULTS
  Seven patients during a 2-year period were noted to have bilateral abductor vocal fold paresis. Five of 7 (71%) had the diagnosis of multiple system atrophy proposed by the laryngologist. All 7 patients described sleep-disordered breathing with stridor.
  
  
  CONCLUSIONS
  Patients with systemic neurodegenerative disorders such as Parkinson disease should be examined for multiple system atrophy and for evidence of bilateral vocal fold paresis. Workup for stridor should include polysomnography. Treatment of glottic obstruction in these patients includes constant positive airway pressure at night or tracheotomy. The finding of bilateral vocal fold paresis can be life threatening.
authors.affiliation: PENN Center for Voice, Pennsylvania Hospital, 800 Spruce St, Philadelphia, PA 19107, USA. bluminj@pahosp.com
authors.forename: Joel H
authors.initials: JH
authors.lastname: Blumin
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Berke
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications*; D017286:Polysomnography; D012135:Respiratory Sounds / Q000175:diagnosis / Q000209:etiology; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000209:etiology*