Prevalence and characterisation of vocal fold motion impairment (VFMI) in patients with Multiple system atrophy compared with Parkinson's disease - 14/09/20
, M. Renaud d , D. Robert b , A. Lagier b , H. Somma c , S. Soulayrol a , D. Korchia b , F. Fluchère a , O. Lagha-Boukbiza f , M. Schaeffer e , T. Witjas a , J.-P. Azulay a , A. Eusebio a Bienvenue sur EM-consulte, la référence des professionnels de santé.
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Highlights |
• | Laryngological examination may help discriminate PD from MSA. |
• | VFMI, in particular VFAM, VFABD, BVFP should be discussed as possible MSA red flag. |
• | BVFP was associated with stridor and dysphagia. |
Abstract |
Introduction |
Multiple system atrophy (MSA) is a neurodegenerative disorder in which vocal fold mobility can be affected, sometimes leading to life-threatening situations. Our aim was to know if laryngeal examination could help differentiate MSA from Parkinson's disease (PD).
Materials and methods |
Between 2004 to 2014, all consecutive patients diagnosed with probable MSA were included in this retrospective, monocentric study. Flexible laryngoscopy was obtained in 51 MSA patients and compared with 27 patients with Parkinson's disease (PD). Laryngeal muscles EMG was available in 6 MSA patients.
Results |
Vocal fold motion impairments (VFMI) was found in 35 (68.6%) MSA patients: 15 (29.4%) had uni- or bilateral vocal fold abnormal movement (VFAM), 13 (25.5%) had uni- or bilateral vocal fold abductor paresis (VFABP), 4 (7.8%) had uni- or bilateral vocal fold adductor paresis (VFADP), 10 (19.6%) had bilateral vocal fold paralysis (BVFP). VFMI was found in 13 PD patients (48.1%) all of whom had VFADP. Presence of BVFP was found associated with stridor (P<0.001) and dysphagia (P=0.002). In all muscles examined in 6 MSA patients, the EMG showed neuropathic patterns.
Conclusions |
Our data support that VFMI may be encountered in two-thirds of MSA with a variable degree of gravity. Laryngological examination should be considered as a supplementary tool for the diagnosis and prognosis of MSA. VFMI in particular VFAM, VFABD and BVFP should be discussed as an additional possible red flag even at an early stage of MSA and could help discriminate MSA from PD.
Le texte complet de cet article est disponible en PDF.Keywords : Multiple system atrophy, Vocal fold motion impairment, Laryngeal examination
Plan
Vol 176 - N° 7-8
P. 608-613 - septembre 2020 Retour au numéro
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