title: Laryngeal dystonia in a case of severe motor and intellectual disabilities due to Japanese encephalitis sequelae.
abstract: 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.
authors.affiliation: 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
authors.forename: Kimiko
authors.initials: K
authors.lastname: Hamano
authors.forename: Satoko
authors.initials: S
authors.lastname: Kumada
authors.forename: Masaharu
authors.initials: M
authors.lastname: Hayashi
authors.forename: Rie
authors.initials: R
authors.lastname: Naito
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Hayashida
authors.forename: Akira
authors.initials: A
authors.lastname: Uchiyama
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Kurata
mesh_terms: 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*