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[Nocturnal stridor in multiple system atrophy].
Ned Tijdschr Geneeskd. 2011; 155(46):A3621.NT

Abstract

BACKGROUND

Multiple system atrophy is a neurodegenerative disorder with parkinsonism, cerebellar ataxia and autonomic dysfunction. The occurrence of nocturnal stridor in patients with multiple system atrophy is associated with a decreased life expectancy. This is what makes adequate treatment so important. Nevertheless, stridor goes often unrecognized and there is frequent uncertainty about the therapeutic options.

CASE

We present a 58-year-old woman with multiple system atrophy and nocturnal stridor. Direct laryngoscopy showed bilateral paresis of the vocal cords and glottic stenosis. Since the outcome of treatment with continuous positive airway pressure (CPAP) was unsatisfactory, a tracheotomy was performed after which the stridor disappeared.

CONCLUSION

Polysomnography and laryngoscopy are the important diagnostic tools for this condition, after the clinical interview. Tracheotomy used to be the only therapeutic option for stridor. However, recent studies show a comparable effectiveness of non-invasive treatment with CPAP, provided there is a correct indication. The choice of therapy is a multidisciplinary process in which the neurologist, the sleep medicine specialist, the otolaryngologist, and the patient are involved.

Authors+Show Affiliations

UMC St Radboud, Afd. Neurologie, Nijmegen, the Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

dut

PubMed ID

22108461

Citation

Louter, Maartje, et al. "[Nocturnal Stridor in Multiple System Atrophy]." Nederlands Tijdschrift Voor Geneeskunde, vol. 155, no. 46, 2011, pp. A3621.
Louter M, Pelleboer RH, van den Broek GB, et al. [Nocturnal stridor in multiple system atrophy]. Ned Tijdschr Geneeskd. 2011;155(46):A3621.
Louter, M., Pelleboer, R. H., van den Broek, G. B., Post, B., Pevernagie, D. A., & Overeem, S. (2011). [Nocturnal stridor in multiple system atrophy]. Nederlands Tijdschrift Voor Geneeskunde, 155(46), A3621.
Louter M, et al. [Nocturnal Stridor in Multiple System Atrophy]. Ned Tijdschr Geneeskd. 2011;155(46):A3621. PubMed PMID: 22108461.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Nocturnal stridor in multiple system atrophy]. AU - Louter,Maartje, AU - Pelleboer,Roel H, AU - van den Broek,Guido B, AU - Post,Bart, AU - Pevernagie,Dirk A A, AU - Overeem,Sebastiaan, PY - 2011/11/24/entrez PY - 2011/11/24/pubmed PY - 2012/1/19/medline SP - A3621 EP - A3621 JF - Nederlands tijdschrift voor geneeskunde JO - Ned Tijdschr Geneeskd VL - 155 IS - 46 N2 - BACKGROUND: Multiple system atrophy is a neurodegenerative disorder with parkinsonism, cerebellar ataxia and autonomic dysfunction. The occurrence of nocturnal stridor in patients with multiple system atrophy is associated with a decreased life expectancy. This is what makes adequate treatment so important. Nevertheless, stridor goes often unrecognized and there is frequent uncertainty about the therapeutic options. CASE: We present a 58-year-old woman with multiple system atrophy and nocturnal stridor. Direct laryngoscopy showed bilateral paresis of the vocal cords and glottic stenosis. Since the outcome of treatment with continuous positive airway pressure (CPAP) was unsatisfactory, a tracheotomy was performed after which the stridor disappeared. CONCLUSION: Polysomnography and laryngoscopy are the important diagnostic tools for this condition, after the clinical interview. Tracheotomy used to be the only therapeutic option for stridor. However, recent studies show a comparable effectiveness of non-invasive treatment with CPAP, provided there is a correct indication. The choice of therapy is a multidisciplinary process in which the neurologist, the sleep medicine specialist, the otolaryngologist, and the patient are involved. SN - 1876-8784 UR - https://www.unboundmedicine.com/medline/citation/22108461/[Nocturnal_stridor_in_multiple_system_atrophy]_ L2 - http://www.ntvg.nl/A3621 DB - PRIME DP - Unbound Medicine ER -