Cases reported "Shy-Drager Syndrome"

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1/5. Management of impaired vocal fold movement during sleep in a patient with shy-drager syndrome.

    A 46-year-old woman with shy-drager syndrome is presented. She has impaired vocal fold abduction during sleep, but has no laryngeal dysfunction while she is awake. In order to reduce laryngeal obstruction during sleep, she initially underwent laterofixation of 1 vocal fold (Ejnell's method) with little lasting success because of accidental slipping of the ligature. Later, she successively underwent arytenoidectomy with the use of CO2 laser. Her noctural breathing improved markedly after arytenoidectomy.
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ranking = 1
keywords = breathing
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2/5. Pathophysiological findings in a patient with Shy-Drager and alveolar hypoventilation syndromes.

    This report describes the clinical, physiologic and pathologic findings in a patient with alveolar hypoventilation, acquired autonomic dysfunction, parkinsonism, and sensorimotor polyneuropathy. While there were pathologic findings in both central and peripheral nervous systems, there were no morphologic changes in the regions of the brainstem considered responsible for respiratory rhythmogenesis. A hypothesis is developed based on the assumption that the abnormalities in respiratory control which led to the patient's death are explained by abnormalities in the feedback control of respiration.
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ranking = 16.418335091632
keywords = respiration
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3/5. respiration and sleep in Parkinson's disease.

    sleep and respiration during sleep were studied in patients with idiopathic Parkinson's disease, patients with Parkinsonism with autonomic disturbance, and normal age and sex matched controls. patients with idiopathic Parkinson's disease showed significantly reduced REM sleep, and more frequent and prolonged waking throughout the night. hypoventilation and sleep apnoea did not occur in the idiopathic Parkinson's disease or normal groups, but respiration was disorganised with frequent central and obstructive apnoeas in the autonomic disturbance group. respiratory rate during non rapid eye movement sleep was similar in the idiopathic Parkinson's disease and normal groups, but patients with idiopathic Parkinson's disease showed tachypnoea awake and during REM sleep.
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ranking = 32.836670183264
keywords = respiration
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4/5. Abductor vocal fold palsy in the shy-drager syndrome presenting with snoring and sleep apnoea.

    The case of an elderly male with shy-drager syndrome is presented. His presentation to the sleep Clinic for assessment of snoring illustrates bilateral abductor vocal fold palsy as a rare presentation of the syndrome. This case emphasizes the need for thorough investigation of all patients with sleep-related breathing disorders with video and sound recordings prior to anaesthesia and surgery.
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ranking = 1
keywords = breathing
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5/5. sleep-related breathing disorders in patients with multiple system atrophy and vocal fold palsy.

    We performed sleep studies in eight patients with multiple system atrophy (MSA) and three patients with peripheral bilateral vocal fold palsy (PBVFP) and investigated stenosis of the upper airway tract during sleep in MSA patients with vocal fold palsy. Among the eight MSA patients in this study, five had definite glottic snoring and two others were suspected of having glottic snoring. Of the PBVFP patients, two had glottic snoring. Three of 11 patients died, and two of the three deaths occurred during sleep. Glottic snoring indicated a high degree of negative esophageal pressure. High negative esophageal pressure demonstrates severe narrowing of the upper airway tract. Therefore, glottic snoring should be considered a risk factor for sudden death in sleep. Repeated laryngoscopic examination is useful in evaluating the progressive process of vocal fold palsy while awake, but this examination performed only while awake is not enough to evaluate narrowing of the upper airway during sleep. sleep studies that include the measurement of esophageal pressure can be very useful in evaluating the severity of narrowing in the upper airway tract. It is suspected that sudden nocturnal death in MSA patients is caused not only by abnormal respiration resulting from impairment of the respiratory center, but also by glottic obstruction caused by sputum or by edema of the vocal folds. We recommend treatment of respiratory disorders when loud laryngeal snoring occurs in patients with MSA, even if they do not complain of dyspnea while awake.
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ranking = 20.418335091632
keywords = respiration, breathing
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