Bilateral abductor vocal fold paralysis due to myasthenia gravis

1999 ◽  
Vol 113 (7) ◽  
pp. 678-679 ◽  
Author(s):  
Victor Osei-Lah ◽  
B. J. O'Reilly ◽  
R. Capildeo
Keyword(s):  
Myasthenia Gravis ◽  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
History Of

AbstractWe report a case of bilateral abductor vocal fold paralysis due to myasthenia gravis in a 61-year-old man who presented with stridor requiring tracheostomy. The stridor had been preceded by several weeks' history of diplopia.

scholarly journals Confounding case of seromucinous hamartoma

2021 ◽  
Vol 14 (3) ◽  
pp. e240460
Author(s):  
Neal Rajan Godse ◽  
Giuseppe Vittorio Staltari ◽  
Katherine Doeden ◽  
Grant Shale Gillman
Keyword(s):  
Myasthenia Gravis ◽  
Vocal Fold ◽  
Cranial Nerves ◽  
Vocal Fold Paralysis ◽  
Seromucinous Hamartoma ◽  
Cranial Neuropathies ◽  
Receptor Antibodies ◽  
Bony Erosion ◽  
Ct And Mri ◽  
Anti Acetylcholine

A 67-year-old man presented with progressive diplopia. On evaluation, he was noted to have bilateral palsies of cranial nerves III, IV and VI as well as a unilateral right true vocal fold paralysis. CT and MRI studies demonstrated a T2-bright left ethmoid mass with no evidence of bony erosion. Direct visualisation demonstrated a polypoid appearing mass of the left sphenoethmoid recess. Operative biopsy was pursued with final pathology demonstrating benign seromucinous hamartoma. Subsequent blood work demonstrated high titres of anti-acetylcholine receptor antibodies consistent with myasthenia gravis. The patient was started on pyridostigmine with improvement in his ocular cranial neuropathies.

Hoarseness due to Mycobacterium kansasii

2008 ◽  
Vol 123 (5) ◽  
pp. 569-571 ◽  
Author(s):  
D Wray ◽  
M O Oko ◽  
D A R Boldy ◽  
M T Butt
Keyword(s):  
Weight Loss ◽  
World Literature ◽  
Vocal Fold ◽  
Sputum Sample ◽  
Vocal Folds ◽  
Vocal Fold Paralysis ◽  
Mycobacterium Kansasii ◽  
Unilateral Vocal Fold Paralysis ◽  
Abnormal Chest ◽  
History Of

AbstractObjective:To present a case of unilateral vocal fold paralysis due to Mycobacterium kansasii induced pressure on the left recurrent laryngeal nerve, a specific aetiology not previously reported in the world literature.Case report:A 57-year-old Caucasian man presented with a short history of productive cough, fever, hoarseness and 14-kg weight loss. He was a smoker, had an abnormal chest X-ray and was human immunodeficiency virus negative. A sputum sample was positive on direct microscopy for acid fast bacilli. Initially, the patient was treated with Rifater (rifampicin, isoniazid and pyrazinamide) and ethambutol. Mycobacterium kansasii was isolated and proved sensitive to this antimycobacterial treatment. Nasoendoscopy revealed diminished movement of the left vocal fold, and a computed tomography scan showed enlarged mediastinal lymph nodes anterior to the aortic arch. After three months of antimycobacterial treatment, the vocal folds were fully mobile at repeat nasoendoscopy, and this coincided with gradual resolution of the patient's hoarseness and weight loss.Conclusions:There are many causes of unilateral vocal fold paralysis. This case illustrates the importance of anatomical knowledge in reaching a diagnosis, and also presents the first reported case of Mycobacterium kansasii creating this clinical picture.

The natural history of recoverable vocal fold paralysis: Implications for kinetics of reinnervation

2017 ◽  
Vol 127 (11) ◽  
pp. 2585-2590 ◽  
Author(s):  
Ted Mau ◽  
Hao-Min Pan ◽  
Lesley F. Childs
Keyword(s):  
Natural History ◽  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
History Of ◽  
Kinetics Of

scholarly journals Bilateral Vocal Fold Paralysis in Myasthenia Gravis: A Case Report and Literature Review

2020 ◽  
Vol 11 ◽  
Author(s):  
Christopher Nelke ◽  
Bendix Labeit ◽  
Sven G. Meuth ◽  
Tobias Warnecke ◽  
Rainer Dziewas ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Myasthenia Gravis ◽  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Bilateral Vocal Fold Paralysis

scholarly journals A UNIQUE CASE OF BILATERAL VOCAL FOLD PARALYSIS FOLLOWING SPINAL ANAESTHESIA

2020 ◽  
Vol 3 ◽  
pp. 3-5
Author(s):  
Manasij Mitra ◽  
Nupur Biswas ◽  
Kumar Shailendra ◽  
Anil Chandra Jain ◽  
Maitraye Basu
Keyword(s):  
Spinal Anaesthesia ◽  
Cranial Nerve ◽  
Vocal Fold ◽  
Case Reports ◽  
Cranial Nerves ◽  
Trochanteric Fracture ◽  
Vocal Fold Paralysis ◽  
Cranial Nerve Palsies ◽  
Bilateral Vocal Fold Paralysis ◽  
History Of

Cranial nerve palsies are potential but rare complications of spinal anaesthesia. Most of the literatures support upper cranial nerve palsies like VI, IV and III cranial nerve palsies. Intrathecal hypotension resulting in tractional injury of the cranial nerves is the likely mechanism of injury. As on date, some cases of unilateral vocal fold paralysis and very little bilateral vocal fold paralysis have been described in case reports. We have described a patient who developed hoarseness and dysphagia 7 days after receiving spinal anaesthesia for fixation of inter-trochanteric fracture femur. The patient was diagnosed with bilateral vocal fold paralysis. He was managed conservatively and exhibited complete spontaneous recovery as has been described in the previously reported cases. Any patient presenting with idiopathic vocal fold paralysis should be enquired about the history of spinal or epidural anaesthesia. If the history is affirmative, then it points towards transient intrathecal hypotension as a potential etiology of the cranial nerve palsy.

Natural history of vocal fold paralysis in Arnold-Chiari malformation

2011 ◽  
Vol 6 (4) ◽  
pp. 256-260 ◽  
Author(s):  
Ericka F. King ◽  
Marike Zwienenberg-Lee ◽  
Steve Maturo ◽  
Peter Siao Tick Chong ◽  
Christopher Hartnick ◽  
...  
Keyword(s):  
Natural History ◽  
Chiari Malformation ◽  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Arnold Chiari Malformation ◽  
History Of

Acute stridor due to bilateral vocal fold paralysis as a presenting sign of myasthenia gravis

1992 ◽  
Vol 106 (8) ◽  
pp. 737-738 ◽  
Author(s):  
James W. Fairley ◽  
Marianne Hughes
Keyword(s):  
Myasthenia Gravis ◽  
Medical Treatment ◽  
Vocal Fold ◽  
Vocal Folds ◽  
Vocal Fold Paralysis ◽  
Bilateral Vocal Fold Paralysis ◽  
Abductor Paralysis ◽  
Prompt Diagnosis

AbstractWe describe a case of myasthenia gravis in a 46-year-old man presenting as acute stridor with bilateral abductor paralysis of the vocal folds. Prompt diagnosis and medical treatment with pyridostigmine avoided the need for tracheostomy. It is important to remember the possibility of myasthenia gravis in cases of stridor due to bilateral vocal fold paralysis, since effective medical treatment is available.

Myasthenia gravis mimicking unilateral vocal fold paralysis at presentation

2006 ◽  
Vol 121 (2) ◽  
pp. 174-178 ◽  
Author(s):  
D M Hartl ◽  
S Leboulleux ◽  
P Klap ◽  
M Schlumberger
Keyword(s):  
Myasthenia Gravis ◽  
Vocal Fold ◽  
Current Knowledge ◽  
Voice Quality ◽  
Vocal Folds ◽  
Flexible Endoscopy ◽  
Clinical Analysis ◽  
Vocal Fold Paralysis ◽  
Motor Deficits ◽  
Unilateral Vocal Fold Paralysis

Objectives: To demonstrate the importance of detailed clinical analysis in the differential diagnosis of unilateral vocal fold paralysis, and to provide an update on current knowledge and treatment of myasthenia gravis.Case report: A female patient presented with left unilateral vocal fold immobility. Diagnostic investigation revealed a 10 mm thyroid adenoma, but no other abnormality likely to cause unilateral vocal fold paralysis. Follow-up flexible endoscopy at three months showed laryngeal remobilisation with persistent left vocal fold bowing and vertical asymmetry of the vocal folds on phonation. Over the following months, voice quality varied between normal and breathy, with the breathy periods lasting from three days to one month. Laryngeal electromyography (EMG) showed a slight bilateral paradoxical activation of both posterior crico-arytenoid muscles on phonation. Magnetic resonance imaging of the brain and brainstem was normal. A diagnostic test for myasthenia gravis with intravenous edrophonium bromide (Tensilon®) lead to an immediate improvement in voice quality. The patient was subsequently treated with pyridostigmine bromide, with complete resolution of dysphonia.Conclusions: Myasthenia gravis affecting the larynx may mimic unilateral vocal fold paresis or paralysis. A personal or family history of auto-immune disease, fluctuating symptoms, motor deficits in cranial nerve territories, and normal or subnormal laryngeal EMG results should lead the physician to reconsider a diagnosis of idiopathic unilateral vocal fold paralysis and to perform specific testing.

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