title: Hoarseness due to bilateral vocal cord paralysis as an initial manifestation of familial amyotrophic lateral sclerosis.
abstract: Bulbar palsy is unusual as an initial manifestation of amyotrophic lateral sclerosis (ALS), although common in the advanced stages. In terms of bulbar palsy as a presenting symptom, dysarthria and dysphagia are of common features. Hoarseness, however, is an initial symptom of ALS in only a small number of patients. We report a 43-year-old female with hoarseness due to bilateral vocal cord paralysis as the first manifestation of ALS. Gene analysis revealed a heterozygous missense mutation in the SOD1 gene, which resulted in an amino acid substitution of isoleucine 149 by threonine. Hoarseness can be the initial symptom of ALS. Therefore, in cases of bilateral vocal cord paralysis of unknown etiology, ALS should be taken into consideration.
authors.affiliation: Department of Neurology, Juntendo University School of Medicine, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Fukae
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Kubo
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hattori
authors.forename: Kaoru
authors.initials: K
authors.lastname: Komatsu
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kato
authors.forename: Masashi
authors.initials: M
authors.lastname: Aoki
authors.forename: Yoshikuni
authors.initials: Y
authors.lastname: Mizuno
mesh_terms: D000328:Adult; D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis* / Q000503:physiopathology*; D005192:Family Health; D005260:Female; D006685:Hoarseness / Q000209:etiology*; D006801:Humans; D007828:Laryngoscopy / Q000379:methods; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000209:etiology*