Multiple System Atrophy With Bilateral Vocal Cord Paralysis: A Case Report

1. Background:Multiple system atrophy (MSA) with bilateral vocal cord paralysis is very rare in the literature. Bilateral vocal cord paralysis could cause fatal inspiratory dyspnea, thus it is important to pay attention to this problem.2. Methods:This case is an inpatient diagnosed in 2008.3. Results:Beside typical clinical manifestation of MSA, including dysautonomia, parkinsonism, cerebellar ataxia, and pyramidal signs, patients could also present as bilateral vocal cord paralysis. T₂ weighted MR image could show bilateral middle cerebellar peduncles hyperintensity. It is practical to treat with tracheotomy.4. Conclusion:It is hard to diagnose MSA at the early period, intensive follow-up is important especially for those patients with poor sleep, stridor, dysarthria, which may indicate bilateral vocal cord paralysis, and we have to intervene at the early stage.