1/22. Neuralgic amyotrophy presenting with bilateral vocal cord paralysis in a child: a case report.Acute stridor and bilateral vocal cord paralysis is not uncommon in the neonate but is unusual in the older child. We report the first case of bilateral vocal cord paralysis secondary to neuralgic amyotrophy, a peripheral polyneuropathy, in a 5-year-old child. An extensive workup revealed a paralyzed right hemidiaphragm, arm weakness and an EMG pattern consistent with neuralgic amyotrophy. Neuralgic amyotrophy is an uncommon disorder in pediatric patients which may involve cranial and peripheral nerves including the phrenic nerves and rarely the recurrent laryngeal nerves. We propose that the diagnosis be considered in children who present with bilateral vocal cord paralysis and other associated neurologic findings.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
2/22. Low-dose vincristine-associated bilateral vocal cord paralysis.BACKGROUND: vincristine-associated peripheral neuropathy is a well-described entity. We describe a case of vincristine-induced vocal cord paralysis, which is a rare complication of this drug. We report herein the second case of bilateral vocal cord paralysis in a patient receiving conventional doses of vincristine. OBJECTIVE: To present a case report of vincristine-associated vocal cord paralysis and to review the relevant English language literature on this subject. DESIGN: Report and review of the literature. SETTING: Outpatient community cancer center. PATIENT: A 58-year-old female with a diffuse large cell lymphoma stage IV receiving cyclophosphamide, doxorubicin, vincristine, and prednisone. RESULTS: Bilateral vocal cord paralysis occurred in this patient receiving vincristine as part of her chemotherapy regimen. In addition to this case there have been a total of 25 prior reports, which are reviewed in the text. CONCLUSION: The incidence of bilateral vocal cord paralysis in patients receiving vincristine on the usual low-dose schedule is low. Prompt withdrawal of the offending agent results in prompt recovery without untoward long-lasting sequela.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
3/22. Hereditary neuropathy and vocal cord paralysis in a man with childhood diphtheria.We present the case of a 37-year-old Afghani man with a history of childhood diphtheria, who was diagnosed with bilateral vocal cord paralysis at age 15 years. At about this time he developed progressive muscular wasting and distally predominant weakness, and subsequently developed respiratory insufficiency, necessitating nocturnal ventilatory support. His examination suggested a distal symmetric sensorimotor neuropathy, and his brother was similarly affected, although to a lesser degree. electromyography (EMG) and nerve conduction studies revealed this process to be purely axonal. A diagnosis of possible hereditary motor and sensory neuropathy (HMSN) type IIc, hereditary axonal polyneuropathy with vocal cord paralysis, is proposed, although the question of early diphtheritic involvement of the vocal cords and peripheral nerves is also considered.- - - - - - - - - - ranking = 7keywords = neuropathy (Clic here for more details about this article) |
4/22. adult-onset familial laryngeal abductor paralysis, cerebellar ataxia, and pure motor neuropathy.Two brothers presented with late-onset cerebellar ataxia and severe dysphonia. brain MRI showed vermian and hemispheric cerebellar atrophy. Laringofiberscopy revealed laryngeal abductor paralysis in both patients. Neurophysiologic studies showed a pure motor neuropathy. The combined findings and the molecular analysis suggest a new familial disorder. Inheritance is most likely autosomal recessive, but X-linked transmission is also possible.- - - - - - - - - - ranking = 5keywords = neuropathy (Clic here for more details about this article) |
5/22. Vagal neuropathy after upper respiratory infection: a viral etiology?PURPOSE: To describe a condition that occurs following an upper respiratory illness, which represents injury to various branches of the vagus nerve. patients with this condition may present with breathy dysphonia, vocal fatigue, effortful phonation, odynophonia, cough, globus, and/or dysphagia, lasting long after resolution of the acute viral illness. The patterns of symptoms and findings in this condition are consistent with the hypothesis that viral infection causes or triggers vagal dysfunction. This so-called postviral vagal neuropathy (PVVN) appears to have similarities with other postviral neuropathic disorders, such as glossopharyngeal neuralgia and Bell's palsy. MATERIALS AND methods: Five patients were identified with PVVN. Each patient's chart was reviewed, and elements of the history were recorded. RESULTS: Each of the 5 patients showed different features of PVVN. CONCLUSIONS: Respiratory infection can trigger or cause vocal fold paresis, laryngopharyngeal reflux, and neuropathic pain.- - - - - - - - - - ranking = 5keywords = neuropathy (Clic here for more details about this article) |
6/22. Congenital hypomyelination neuropathy in a newborn infant: unusual cause of diaphragmatic and vocal cord paralyses.We report a case of congenital hypomyelination neuropathy presenting at birth. The infant had generalized hypotonia and weakness. There was decreased respiratory effort along with a right phrenic nerve and left vocal cord paralyses. tongue fasciculations were present. Deep tendon reflexes were absent in the upper extremities and hypoactive (1 ) in the lower extremities. magnetic resonance imaging of the head revealed no intracranial abnormalities, including normal cerebral myelination. Nerve conduction study showed absence of motor and sensory action potentials in the hands when the nerves in the upper limbs were stimulated. A motor response could be elicited only in the proximal leg muscles. Needle electromyography study was normal in the proximal limb muscles, but showed active denervation in the distal muscles of the arm and leg. These findings were thought to be consistent with a length-dependent sensorimotor peripheral polyneuropathy of axonal type with greater denervation of the distal muscles. A biopsy of the quadriceps muscle showed mild variability in fiber diameter, but no group typing or group atrophy. The muscle fibers showed no intrinsic abnormalities. biopsy of the sural nerve showed scattered axons with very thin myelin sheaths. There was also a nearly complete loss of large diameter myelinated fibers. No onion bulb formations were noted. These findings were thought to be consistent with congenital hypomyelination neuropathy with a component of axonopathy. dna analysis for identification of previously characterized mutations in the genes MPZ, PMP22, and EGR2 was negative. Several attempts at extubation failed and the infant became increasingly ventilator-dependent with increasing episodes of desaturation and hypercapnea. He also developed increasing weakness and decreased movement of all extremities. He underwent surgery at 2 months of age for placement of a gastrostomy tube and a tracheostomy. He was discharged from the hospital on a ventilator at 6 months of age. The infant was 13 months old at the time of submission of this report. Although he appears cognitively normal, he remains profoundly hypotonic and is on a home ventilator. There was no evidence of progressive weakness. Congenital hypomyelination neuropathy is a rare form of neonatal neuropathy that should be considered in the differential diagnosis of a newborn with profound hypotonia and weakness. It appears to be a heterogeneous disorder with some of the cases being caused by specific genetic mutations.- - - - - - - - - - ranking = 9keywords = neuropathy (Clic here for more details about this article) |
7/22. Bilateral vocal fold palsy caused by chronic motor axonal neuropathy.The authors report a first case of chronic motor axonal neuropathy involving ENT manifestations, in a 64-year-old male presenting with gait difficulties, effort dyspnoea and dysphonia. Eleven months after the first symptoms, he developed severe hypoventilation, limb weakness and bilateral vocal fold palsy and had to be intubated for respiratory failure. The diagnosis of chronic motor axonal neuropathy was suspected on clinical and electrophysiological grounds. The patient improved dramatically after a five-day course of 0.4 g/kg intravenous immunoglobulin. He is still being treated with methylprednisolone 0.5 mg/kg every other day and remains stable. We conclude the bilateral vocal fold palsy may be associated with chronic motor axonal neuropathy and that the immunosuppressive treatment may be effective in such cases.- - - - - - - - - - ranking = 7keywords = neuropathy (Clic here for more details about this article) |
8/22. Unusual neurological presentations of vitamin B(12) deficiency.Vitamin B(12) deficiency (B(12)D) has a wide variety of neurological symptoms and signs. However, cerebellar dysfunction and cranial neuropathies other than optic neuropathy have been rarely reported. Herein, we describe two cases of unusual neurological manifestations of B(12)D. One patient showed prominent hoarseness with vocal cord paralysis, myelopathy, and peripheral neuropathy. The other had gait disturbance, lateral gaze limitation and cerebellar dysfunction in addition to the typical manifestations of subacute combined degeneration. Vitamin B(12) deficiency can rarely affect cerebellum and cranial nerves other than optic nerve.- - - - - - - - - - ranking = 2keywords = neuropathy (Clic here for more details about this article) |
9/22. Tapia's syndrome following septorhinoplasty.No surgery is free of complications varying from common minor problems to very unexpected and severe ones. In the case presented here, unilateral paralysis of the muscles of the tongue and ipsilateral vocal cord paralysis due to a lesion of the 10th and 12th cranial nerves occurred following a septorhinoplasty that was performed under endotracheal general anesthesia. This rare entity known as Tapia's syndrome is believed to be caused by pressure neuropathy of both nerves due to inflation of the cuff within the larynx. We remind surgeons of this unusual complication that can occur in any surgery under general anesthesia and discuss its diagnosis, treatment method, and the followup results in light of the literature.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
10/22. Hereditary motor and sensor neuropathy: a cause of acute stridor.We present an acute stridor secondary to bilateral vocal cord paresis in a patient with demyelinating form (type I) of hereditary motor and sensory neuropathy (HMSN). Management problems are discussed and HMSN reviewed.- - - - - - - - - - ranking = 5keywords = neuropathy (Clic here for more details about this article) |
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