title: Laryngeal dystonia in the course of multiple system atrophy: a cause of postoperative respiratory insufficiency.
abstract: Multiple system atrophy (MSA) is an adult onset, incurable neurodegenerative disease, characterized by symptoms of nervous system failure. Occurrence of laryngeal dystonia indicates increased risk of sudden death caused by airway occlusion. We present the case report of 63-year-old patient with history of orthostatic hypotension, parkinsonism, progressive adynamia, and stridor. The patient was admitted to the hospital for diagnosis of orthostatic hypotension. A diagnosis of possible MSA was made. Because of patient's complaints, an X-ray of the hip joint was taken. It revealed femoral neck fracture. Endoprosthesis insertion under general anesthesia was performed. Two days later the patient presented progressive adynamy and respiratory insufficiency. Endotracheal intubation and respiratory support were required followed by extubation and one more intubation. After second extubation, stridor and acute respiratory insufficiency occurred. Urgent tracheostomy was performed. After 13 days in ICU, the patient was discharged to the rehabilitation center.
authors: Department of Anaesthesiology and Intensive Therapy, Medical University of Gdańsk, Ul. Dębinki 7, 80-211, Gdańsk, Poland. magwuj@gumed.edu.pl
authors: Magdalena A
authors: MA
authors: Wujtewicz
authors: Kamil
authors: K
authors: Chwojnicki
authors: Radosław
authors: R
authors: Owczuk
authors: Maria
authors: M
authors: Wujtewicz
mesh_terms: D004421:Dystonia / Q000150:complications / Q000209:etiology*; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications / Q000601:surgery; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007818:Laryngeal Diseases / Q000150:complications / Q000209:etiology*; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications / Q000601:surgery; D011183:Postoperative Complications / Q000503:physiopathology*; D012131:Respiratory Insufficiency / Q000209:etiology*; D014139:Tracheostomy / Q000009:adverse effects*