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Non-invasive positive pressure ventilation for laryngeal contraction disorder during sleep in multiple system atrophy.
J Neurol Sci. 2006 Aug 15; 247(1):53-8.JN

Abstract

We examined the usefulness of non-invasive positive pressure ventilation (NPPV) in the management of nocturnal laryngeal stridor associated with vocal cord dysfunction in five cases of multiple system atrophy (MSA). First, the patients were investigated during sleep induced by a minimal dose of propofol. Laryngoscopy showed paradoxical vocal cord movement resulting in inspiratory stridor. Electromyographic (EMG) study revealed synchronized bursts in the thyroarytenoid muscles and diaphragm in every inspiratory phase whenever the stridor emerged. NPPV was initiated after paradoxical movement was recognized with laryngoscopy. The NPPV mask was equipped with an additional channel for laryngoscopic monitoring. The optimal pressure for treatment was determined according to laryngoscopic and EMG findings. Next, NPPV was applied to natural sleep using the conditions determined in propofol-induced sleep. In all cases, NPPV eliminated nocturnal stridor and oxygen desaturation during natural sleep. Laryngoscopic observation during induced sleep is recommended as a useful procedure to titrate the optimal pressure for NPPV therapy. Since central hypoventilation progresses in the course of MSA, the choice of NPPV rather than continuous positive airway pressure should be encouraged to treat laryngeal contraction disorder associated with MSA.

Authors+Show Affiliations

Department of Neurology, Sapporo Medical University School of Medicine, Minami 1-Jo Nishi 16-Chome, Sapporo, Japan. mnonaka@sapmed.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16647088

Citation

Nonaka, Michio, et al. "Non-invasive Positive Pressure Ventilation for Laryngeal Contraction Disorder During Sleep in Multiple System Atrophy." Journal of the Neurological Sciences, vol. 247, no. 1, 2006, pp. 53-8.
Nonaka M, Imai T, Shintani T, et al. Non-invasive positive pressure ventilation for laryngeal contraction disorder during sleep in multiple system atrophy. J Neurol Sci. 2006;247(1):53-8.
Nonaka, M., Imai, T., Shintani, T., Kawamata, M., Chiba, S., & Matsumoto, H. (2006). Non-invasive positive pressure ventilation for laryngeal contraction disorder during sleep in multiple system atrophy. Journal of the Neurological Sciences, 247(1), 53-8.
Nonaka M, et al. Non-invasive Positive Pressure Ventilation for Laryngeal Contraction Disorder During Sleep in Multiple System Atrophy. J Neurol Sci. 2006 Aug 15;247(1):53-8. PubMed PMID: 16647088.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-invasive positive pressure ventilation for laryngeal contraction disorder during sleep in multiple system atrophy. AU - Nonaka,Michio, AU - Imai,Tomihiro, AU - Shintani,Tomoko, AU - Kawamata,Mikito, AU - Chiba,Susumu, AU - Matsumoto,Hiroyuki, Y1 - 2006/04/27/ PY - 2005/03/16/received PY - 2006/03/06/revised PY - 2006/03/08/accepted PY - 2006/5/2/pubmed PY - 2006/11/4/medline PY - 2006/5/2/entrez SP - 53 EP - 8 JF - Journal of the neurological sciences JO - J. Neurol. Sci. VL - 247 IS - 1 N2 - We examined the usefulness of non-invasive positive pressure ventilation (NPPV) in the management of nocturnal laryngeal stridor associated with vocal cord dysfunction in five cases of multiple system atrophy (MSA). First, the patients were investigated during sleep induced by a minimal dose of propofol. Laryngoscopy showed paradoxical vocal cord movement resulting in inspiratory stridor. Electromyographic (EMG) study revealed synchronized bursts in the thyroarytenoid muscles and diaphragm in every inspiratory phase whenever the stridor emerged. NPPV was initiated after paradoxical movement was recognized with laryngoscopy. The NPPV mask was equipped with an additional channel for laryngoscopic monitoring. The optimal pressure for treatment was determined according to laryngoscopic and EMG findings. Next, NPPV was applied to natural sleep using the conditions determined in propofol-induced sleep. In all cases, NPPV eliminated nocturnal stridor and oxygen desaturation during natural sleep. Laryngoscopic observation during induced sleep is recommended as a useful procedure to titrate the optimal pressure for NPPV therapy. Since central hypoventilation progresses in the course of MSA, the choice of NPPV rather than continuous positive airway pressure should be encouraged to treat laryngeal contraction disorder associated with MSA. SN - 0022-510X UR - https://www.unboundmedicine.com/medline/citation/16647088/Non_invasive_positive_pressure_ventilation_for_laryngeal_contraction_disorder_during_sleep_in_multiple_system_atrophy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-510X(06)00128-6 DB - PRIME DP - Unbound Medicine ER -