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Min-Chul Kim 1 Article
Neurology
Multiple System Atrophy Manifested by Bilateral Vocal Cord Palsy as an Initial Sign
Yuri Seo, Soomin Jeung, Heeyoung Yoon, Min-Chul Kim, Nah Kyum Lee, Byeong Zu Ghang, Sun Ju Chung, Younsuck Koh
Korean J Crit Care Med. 2015;30(2):123-127.   Published online May 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.2.123
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A 71-year-old male initially presented with vocal cord palsy and underwent tracheostomy. After thorough examination, urogenital dysfunction, orthostatic hypotension, and Parkinsonism were found, which led to the diagnosis of multiple system atrophy (MSA). After the tracheostomy, bi-level positive airway pressure ventilation was required during the night due to nocturnal hypoxemia. Nighttime hypoxemia is related to central sleep apnea, which is one of the manifestations of MSA. This is the first case of MSA manifested by bilateral vocal cord palsy as an initial sign in Korea. This case supports the notion that MSA should be taken into consideration when vocal cord paralysis is observed.

ACC : Acute and Critical Care