Laryngeal dystonia in a case of severe motor and intellectual disabilities due to Japanese encephalitis sequelae.
Laryngeal dystonia is characterized by stridor due to vocal cord dystonia and is observed in extrapyramidal disorders. Recently, botulinum toxin injection has been used as a primary therapy. Generally, severe motor and intellectual disabilities (SMID) are frequently complicated by various types of respiratory disorders. We report a SMID case with Japanese encephalitis sequelae showing repeated vocal cord abductor disturbance due to laryngeal dystonia, in addition to generalized dystonia, in whom MRI revealed basal ganglia lesions. Tracheostomy was effective for the case, and we believe that botulinum toxin injection may be inappropriate in SMID, both ethically and technically. Also, laryngeal dystonia should be considered as a cause of respiratory disorders in SMID.
Hamano
Kimiko
K
Department of Pediatrics, Metropolitan Fuchu Medical Center for Severe Motor and Intellectual Disabilities, 2-9-2 Musashidai, Fuchu-shi, Tokyo 183-0042, Japan. k-hama@msi.biglobe.ne.jp
Kumada
Satoko
S
Hayashi
Masaharu
M
Naito
Rie
R
Hayashida
Tetsuro
T
Uchiyama
Akira
A
Kurata
Kiyoko
K
D001479:Basal Ganglia / Q000473:pathology; D004421:Dystonia / Q000209:etiology*; D004576:Electromyography; D004672:Encephalitis, Japanese / Q000150:complications*; D005260:Female; D006801:Humans; D007360:Intelligence; D008279:Magnetic Resonance Imaging; D001523:Mental Disorders / Q000209:etiology*; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology*; D012140:Respiratory Tract Diseases / Q000209:etiology / Q000601:surgery; D014139:Tracheostomy; D014826:Vocal Cord Paralysis / Q000209:etiology*