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.

Links

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Authors+Show Affiliations

Heo SJ
Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital.
Kim JS
Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital.
Lee BJ
Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea.
Park D
Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.

MeSH

EndoscopyFemaleHumansHypnotics and SedativesMidazolamMiddle AgedMultiple System AtrophyRespiratory SoundsSleep Apnea Syndromes

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32311969