title: [Pathological study on abducent paralysis of the vocal cord in a patient having multiple system atrophy with nasogastric intubation].
abstract: A 74-year-old man developed instability of gait from age 64, difficulty in writing from age 66 and dysarthria-hypohidrosis from around age 67. These symptoms progressed slowly accompanied with orthostatic hypotension and dysarthria, which decline his ADL. At age 71, he was admitted to our hospital and underwent nasogastric intubation. After admission, he also showed the decrease in his voluntary activities, accidental ingestion and loud snoring during sleep. He died of accidental aspiration pneumonia at age 74. Postmortem examination revealed severe pathological changes as multiple system atrophy (MSA) in the central nervous system. There was a small ulcer in the hypopharyngeal region, and acute inflammation of the ulcer came down to the posterior cricoarytenoid muscle. Combined with severe neurogenic atropy due to MSA, local inflammation of the ulcer associated with nasogastric intubation appeared to have resulted in severe damage of the posterior cricoarytenoid muscle.
authors.affiliation: Department of Neurology, Neuro-Muscular Center, National Omuta Hospital.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Nagata
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kamei
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Furuya
authors.forename: Naoki
authors.initials: N
authors.lastname: Fujii
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Noda
authors.forename: Toru
authors.initials: T
authors.lastname: Iwaki
mesh_terms: D020434:Abducens Nerve Diseases / Q000209:etiology* / Q000473:pathology*; D000368:Aged; D001344:Autopsy; D017809:Fatal Outcome; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D008297:Male; D019578:Multiple System Atrophy / Q000150:complications* / Q000473:pathology*; D018482:Muscle, Skeletal / Q000473:pathology; D011015:Pneumonia, Aspiration / Q000209:etiology; D012009:Recurrent Laryngeal Nerve / Q000473:pathology; D014826:Vocal Cord Paralysis / Q000209:etiology* / Q000473:pathology*