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Isolated stridor without any other sleeping breathing disorder diagnosed using drug-induced sleep endoscopy in a patient with multiple system atrophy: A case report.
Medicine (Baltimore). 2020 Apr; 99(16):e19745.M

Abstract

RATIONALE

Multiple system atrophy (MSA) is a rare neurodegenerative disease characterized by Parkinsonism and autonomic dysfunction or cerebellar ataxia. MSA can be accompanied by stridor caused by laryngeal stenosis secondary to vocal cord dysfunction.

PATIENT CONCERN

A 60-year-old woman with MSA, complaining of difficulty in breathing during sleep. Her bed partner reported witnessing grunting-like sounds during sleep.

DIAGNOSIS

Isolated stridor without any other sleeping breathing disorder diagnosed using drug-induced sleep endoscopy (DISE) in a patient with MSA.

INTERVENTIONS

On polysomnography, there was no obstructive sleep apnea. Using DISE, abnormally adducted vocal cords during inspiratory respiration were identified, leading to a diagnosis of stridor. We prescribed positive airway pressure to resolve the stridor.

OUTCOME

Our patient was also prescribed continuous positive airway pressure for the treatment of nocturnal stridor, and it is improved.

LESSONS

In summary, when MSA patients present with nocturnal stridor, it is important to evaluate the exact diagnosis and cause of stridor in patients by confirming the movement of vocal cords using DISE, as well as polysomnography.

Authors+Show Affiliations

Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital.Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital.Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea.Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32311969

Citation

Heo, Sung Jae, et al. "Isolated Stridor Without Any Other Sleeping Breathing Disorder Diagnosed Using Drug-induced Sleep Endoscopy in a Patient With Multiple System Atrophy: a Case Report." Medicine, vol. 99, no. 16, 2020, pp. e19745.
Heo SJ, Kim JS, Lee BJ, et al. Isolated stridor without any other sleeping breathing disorder diagnosed using drug-induced sleep endoscopy in a patient with multiple system atrophy: A case report. Medicine (Baltimore). 2020;99(16):e19745.
Heo, S. J., Kim, J. S., Lee, B. J., & Park, D. (2020). Isolated stridor without any other sleeping breathing disorder diagnosed using drug-induced sleep endoscopy in a patient with multiple system atrophy: A case report. Medicine, 99(16), e19745. https://doi.org/10.1097/MD.0000000000019745
Heo SJ, et al. Isolated Stridor Without Any Other Sleeping Breathing Disorder Diagnosed Using Drug-induced Sleep Endoscopy in a Patient With Multiple System Atrophy: a Case Report. Medicine (Baltimore). 2020;99(16):e19745. PubMed PMID: 32311969.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Isolated stridor without any other sleeping breathing disorder diagnosed using drug-induced sleep endoscopy in a patient with multiple system atrophy: A case report. AU - Heo,Sung Jae, AU - Kim,Jung Soo, AU - Lee,Byung Joo, AU - Park,Donghwi, PY - 2020/4/22/entrez PY - 2020/4/22/pubmed PY - 2020/4/25/medline SP - e19745 EP - e19745 JF - Medicine JO - Medicine (Baltimore) VL - 99 IS - 16 N2 - RATIONALE: Multiple system atrophy (MSA) is a rare neurodegenerative disease characterized by Parkinsonism and autonomic dysfunction or cerebellar ataxia. MSA can be accompanied by stridor caused by laryngeal stenosis secondary to vocal cord dysfunction. PATIENT CONCERN: A 60-year-old woman with MSA, complaining of difficulty in breathing during sleep. Her bed partner reported witnessing grunting-like sounds during sleep. DIAGNOSIS: Isolated stridor without any other sleeping breathing disorder diagnosed using drug-induced sleep endoscopy (DISE) in a patient with MSA. INTERVENTIONS: On polysomnography, there was no obstructive sleep apnea. Using DISE, abnormally adducted vocal cords during inspiratory respiration were identified, leading to a diagnosis of stridor. We prescribed positive airway pressure to resolve the stridor. OUTCOME: Our patient was also prescribed continuous positive airway pressure for the treatment of nocturnal stridor, and it is improved. LESSONS: In summary, when MSA patients present with nocturnal stridor, it is important to evaluate the exact diagnosis and cause of stridor in patients by confirming the movement of vocal cords using DISE, as well as polysomnography. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/32311969/Isolated_stridor_without_any_other_sleeping_breathing_disorder_diagnosed_using_drug_induced_sleep_endoscopy_in_a_patient_with_multiple_system_atrophy:_A_case_report_ L2 - https://doi.org/10.1097/MD.0000000000019745 DB - PRIME DP - Unbound Medicine ER -