Stridor: a rare presentation of motor neuron disease

2021 ◽  
Vol 14 (7) ◽  
pp. e241923
Author(s):  
Brian Gordon ◽  
Eimear Joyce ◽  
Timothy J Counihan
Keyword(s):  
Motor Neuron ◽  
Motor Neuron Disease ◽  
Vocal Cord ◽  
Poor Response ◽  
Vocal Cord Palsy ◽  
Pharmacological Therapy ◽  
Rare Presentation ◽  
Emergency Tracheostomy ◽  
Life Threatening ◽  
History Of

A 74-year-old farmer presented to the emergency department with a subacute history of progressive dyspnoea, wheeze and dysphonia. He was treated for an exacerbation of asthma with poor response to pharmacological therapy. Investigation of dysphonia via laryngoscopy identified a bilateral vocal cord palsy. Subsequently, the patient developed an episode of life-threatening stridor and hypercapnic respiratory failure requiring an emergency tracheostomy. Neurology input identified evidence of widespread muscle fasciculations on clinical examination. MRI of the brain and cervical spine were unremarkable. Electromyogram testing identified changes of acute denervation in several limbs consistent with a diagnosis of motor neuron disease (MND). Bilateral vocal cord palsy has been rarely reported in the literature as the heralding symptom resulting in the diagnosis of MND. In patients with a subacute onset of dysphonia, dyspnoea and stridor, MND should be a differential diagnosis.

Natural history of motor neuron disease

2009 ◽  
pp. 36-47
Author(s):  
Kevin Talbot ◽  
Martin R. Turner ◽  
Rachael Marsden ◽  
Rachel Botell
Keyword(s):  
Natural History ◽  
Motor Neuron ◽  
Motor Neuron Disease ◽  
History Of

scholarly journals Asymptomatic aortic aneurysm causing right vocal cord palsy and hoarseness: A rare presentation

2014 ◽  
Vol 8 (3) ◽  
pp. 397
Author(s):  
RajBahadur Singh ◽  
Anuj Jain ◽  
Arindam Sarkar ◽  
MM Rizvi
Keyword(s):  
Aortic Aneurysm ◽  
Vocal Cord ◽  
Vocal Cord Palsy ◽  
Rare Presentation

scholarly journals Fish Bone Migration- Culprit Leading to RetroParaoesophageal Abscess, Mediastinitis and Vocal Cord Palsy

2020 ◽  
Vol 18 (3) ◽  
Author(s):  
Paul M ◽  
Shashigopalan M ◽  
Johnson NWS
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Palsy ◽  
Fish Bone ◽  
Neck Exploration ◽  
Oesophageal Perforation ◽  
Anatomical Features ◽  
Vocal Cord Paresis ◽  
Life Threatening

Fish bone ingestion and impaction are known to everyone. However, such benign incidences have been reported to be associated with multiple potentially life threatening complications. Anatomical features of the oesophagus forms the basis for such incidences. We report here an elderly diabetic gentleman with an unusual left retro-paraoesophageal abscess complicated with oesophageal perforation, mediastinitis and vocal cord paresis which were fundamentally caused by a migrated fish bone into the lower part of the neck requiring therapeutic external neck exploration. Management of this case and its complications are described here comprehensively.

scholarly journals Correlation of electroglottograph with vocal cord pathology

2016 ◽  
Vol 3 (1) ◽  
pp. 46 ◽  
Author(s):  
Shilpa Chandrashekarappa ◽  
Sandeep S. ◽  
Sandeep Jain ◽  
Guruswamy M. ◽  
Shivaram T. Shetty
Keyword(s):  
Vocal Cord ◽  
Clinical Examination ◽  
Cost Effective ◽  
Vocal Cord Palsy ◽  
Mass Lesion ◽  
Closing Time ◽  
Vocal Cords ◽  
Significant Difference ◽  
Invasive Method ◽  
History Of

<p class="abstract"><strong>Background:</strong> Vocal cord disorders are very commonly encountered in ENT Outpatient. Electroglottogram is a non-invasive method for the examination of the vocal fold vibrations.  It exerts no influence at all on articulation and production of sound and is cost effective. The aim of the present study was to validate the clinical correlation of electroglottogram in patients presenting with hoarseness of voice<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> 30 patients with history of hoarseness of voice and 30 normals were selected from ENT outpatient and inpatient department over a period of 2 years. All subjects underwent detailed ENT history taking, clinical examination, rigid laryngoscopy and electroglottography and results were documented<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> Electroglottography waveforms of various voice disorders like vocal cord nodule, polyp, papilloma and haemangioma showed specific changes like double peak or notch in closing phase of waveform in case of mass lesion over the vocal cords and fuzzy waveform with prolonged closing time in case of vocal cord palsy. Significant difference was noted in certain electroglottographic parameters for phonated vowels /a/, /i/ and /u/ for certain vocal cord disorders<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Electroglottograph helps in diagnosing the pathology related to vocal cords, whether it is mass lesion over the vocal cords or vocal cord palsy but to differentiate in between mass lesions, clinical examination has to be done to confirm the diagnosis<span lang="EN-IN">.</span></p>

scholarly journals Spontaneous Gastric Necrosis: A Rare Presentation of Invasive Mucormycosis in an Immunocompetent Adult

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Tariq Hameed ◽  
Sudhir Kumar Jain ◽  
Faiz Manzar Ansari ◽  
Adiba Nizam ◽  
Amrita Dua
Keyword(s):  
Surgical Excision ◽  
Young Female ◽  
Immunocompetent Adult ◽  
Rare Presentation ◽  
Ulcer Disease ◽  
Pain Abdomen ◽  
Life Threatening ◽  
History Of ◽  
Intravenous Amphotericin ◽  
Immunocompetent Adults

Spontaneous gastric perforations are usually seen in patients with untreated peptic ulcer disease. Mucormycosis, an uncommon, opportunistic, life-threatening fungal infection, rarely causes gastric perforation in immunocompetent adults. Here, we present a case of young female who was admitted to hospital for acute pain abdomen and distension with 5 days history of fever. She was operated and was found to have multiple perforations in the stomach with transmural necrosis. Despite adequate surgical excision and intravenous amphotericin B, patient succumbed to sequelae of infection.

Presentation of motor neuron disease in a patient with weight loss and acute-on-chronic respiratory failure

2021 ◽  
Vol 14 (4) ◽  
pp. e238789
Author(s):  
Tak Wai Chan
Keyword(s):  
Weight Loss ◽  
Respiratory Failure ◽  
Motor Neuron ◽  
Motor Neuron Disease ◽  
Chronic Type ◽  
Acute Medical Unit ◽  
History Of ◽  
Specific Symptoms ◽  
Remote Consultations

A previously fit and well 72-year-old man was referred to the acute medical unit with acute shortness of breath and confusion. He had presented 6 months earlier to his General Practitioner with a 6-month history of weight loss and lethargy. Despite CT imaging and extensive blood tests, no cause was found. He was having ongoing outpatient investigations, including a respiratory review leading up to his admission; the deterioration in his condition also coincided with the implementation of the COVID-19 lockdown. On admission, he was found to be in acute-on-chronic type 2 respiratory failure; examination revealed scattered fasciculations. Further inpatient electromyography (EMG) and nerve conduction study (NCS) confirmed motor neuron disease (MND). This case highlighted the importance of considering neuromuscular causes for acute respiratory failure in acute presentations and demonstrated the challenges in the diagnosis of MND in those presenting atypically with non-specific symptoms and the limitations of remote consultations in complex cases.

scholarly journals Sensory Neuron Degeneration in Familial Kugelberg-Welander Disease

1989 ◽  
Vol 16 (1) ◽  
pp. 67-70 ◽  
Author(s):  
Toni R. Winder ◽  
Roland N. Auer
Keyword(s):  
Motor Neuron ◽  
Motor Neuron Disease ◽  
Sensory Neurons ◽  
Dorsal Root Ganglia ◽  
Dorsal Root ◽  
Cell Loss ◽  
Motor Deficits ◽  
History Of ◽  
Nuclear Changes ◽  
Phrenic Nucleus

ABSTRACT:A 53 year old man developed symptoms of motor neuron disease in childhood. There was a family history of a similar disorder and it was felt to represent a form of Kugelberg-Welander disease. In addition to the motor deficits, sensory abnormalities in his legs were documented during life. Autopsy revealed anterior horn cell loss throughout the length of the spinal cord, with preservation of the phrenic nucleus. The lumbar dorsal root ganglia showed active degeneration of sensory neurons, with nuclear changes exceeding cytoplasmic ones. The fasciculus gracilis showed Wallerian degeneration. The findings provide direct evidence that sensory neurons can degenerate in some forms of motor neuron disease, and that the “demyelination” or “degeneration” of posterior columns sometimes seen in the various forms of motor neuron disease may actually be secondary to cell body disease in the dorsal root ganglia.

Acute upper airway obstruction following Teflon injection of a vocal cord; the value of nebulized adrenaline and a helium/oxygen mixture in its management

1990 ◽  
Vol 104 (8) ◽  
pp. 654-655 ◽  
Author(s):  
Neil B. Solomons ◽  
Jonathan R. Livesey
Keyword(s):  
Airway Obstruction ◽  
Vocal Cord ◽  
Upper Airway ◽  
Vocal Cord Palsy ◽  
Upper Airway Obstruction ◽  
Oxygen Mixture ◽  
Post Operative Period ◽  
History Of ◽  
The Right

AbstractA 67-year-old man presented with a 45-year history of a weak voice. This was the result of polio which had left him with a right vocal cord palsy.The patient underwent a Teflon injection of the right vocal cord under general anaesthesia to improve the quality of his voice. In the immediate post-operative period, he suffered acute upper airway obstruction. The problem of acute upper airway obstruction following Teflon injection is considered and its management with nebulized adrenaline and a helium/oxygen mixture is discussed.

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