Multiple system atrophy as a cause of upper airway obstruction

Lim, Yong; Kennedy, N.

doi:10.1111/j.1365-2044.2007.05227.x

Cited by 13 publications

(10 citation statements)

References 11 publications

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“…Neuronal degeneration in Onuf's nucleus located in spinal segment S2-S4 causes damage to the sacral spinal cord innervating the bladder and rectal sphincter, which in turn leads to clinical signs of defecatory and urinary dysfunction. Previous studies have shown [20][21][22][23][24] that about 76% of patients who were eventually diagnosed with MSA complained of symptoms of abnormal sacral spinal cord function when presenting to a doctor. ese symptoms primarily consist of constipation, urinary retention, urinary incontinence, impotence, and hypotension associated with postural changes.…”

Section: Discussionmentioning

confidence: 99%

Sacral Reflex Characteristics of Patients with Multiple System Atrophy

Pan

Zhang

Wang

et al. 2020

Parkinson's Disease

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Objectives. To observe and analyze the parameters of the sacral reflex and pudendal nerve somatosensory evoked potential (SSEP) in patients with multiple system atrophy (MSA) with respect to factors such as age, disease course, and subtype and provide evidence for the clinical diagnosis of MSA. Materials and Methods. A total of 51 MSA patients and 30 healthy controls were selected from the First Affiliated Hospital of Wenzhou Medical University from May 2013 to November 2015. Electrophysiological sacral reflex detection and SSEP detection were performed using the Keypoint EMG/EP system. The extraction rate, latency, and amplitude of the sacral reflex and SSEP in the MSA group and control group were compared. Results. The sacral reflex latency and amplitude in patients with MSA were statistically different from those of the healthy controls. The latency of sacral reflex increases with the prolongation of the disease course, and the amplitude and initiation rate decrease with the prolongation of the disease course. There was no significant difference in sacral reflex latency and amplitude between MSA patients of different ages and subtypes. There was no significant difference in the latency or amplitude of SSEP between the MSA group and healthy control group. Conclusions. The latency of sacral reflex increases with the prolongation of the disease course, and the amplitude and extraction rate decrease with the prolongation of the disease course. There was no significant difference in the parameters of sacral reflex between young MSA patients and elderly patients. And there was no statistically significant difference between MSA-P subtypes and MSA-C subtypes. This trial is registered with ISRCTNCR2009041.

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Section: Discussionmentioning

confidence: 99%

Sacral Reflex Characteristics of Patients with Multiple System Atrophy

Pan

Zhang

Wang

et al. 2020

Parkinson's Disease

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“…However, spinal anesthesia can also be suitable in such patients [ 13 ]. Dangerous airway obstruction upon induction of or emergence from general anesthesia may occur, but this obstruction is relatively easy to overcome by applying minimal positive pressure [ 14 ]. There were no such complications in this case.…”

Section: Discussionmentioning

confidence: 99%

Laryngeal dystonia in the course of multiple system atrophy: a cause of postoperative respiratory insufficiency

et al. 2011

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Multiple system atrophy (MSA) is an adult onset, incurable neurodegenerative disease, characterized by symptoms of nervous system failure. Occurrence of laryngeal dystonia indicates increased risk of sudden death caused by airway occlusion. We present the case report of 63-year-old patient with history of orthostatic hypotension, parkinsonism, progressive adynamia, and stridor. The patient was admitted to the hospital for diagnosis of orthostatic hypotension. A diagnosis of possible MSA was made. Because of patient’s complaints, an X-ray of the hip joint was taken. It revealed femoral neck fracture. Endoprosthesis insertion under general anesthesia was performed. Two days later the patient presented progressive adynamy and respiratory insufficiency. Endotracheal intubation and respiratory support were required followed by extubation and one more intubation. After second extubation, stridor and acute respiratory insufficiency occurred. Urgent tracheostomy was performed. After 13 days in ICU, the patient was discharged to the rehabilitation center.

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“…The inferior olives and the dorsal motor nucleus of the vagus and pyramidal tracts are also affected. The smaller diameter fibers of the autonomic nervous system appear to be the first involved, followed by the gamma fibers and alpha fibers [1, 9]. The clinical diagnosis of MSA is difficult and there are no pathognomonic features to discriminate the Parkinsonian variant (MSA-P) from Parkinson's disease.…”

Section: Discussionmentioning

confidence: 99%

“…In the current case, the patient presented clinical and imaging criteria that could establish MSA as possible diagnosis. This procedure was not usual since the main complaints (respiratory insufficiency and vocal cords paralysis) are rare manifestations of MSA and only few articles relating these to MSA can be found in literature [7–9, 11, 12]. In 2006, Glass et al [12] reported 6 cases of irregularities in respiration that may occasionally arise in an early stage of MSA and may be clues to diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Multiple-System Atrophy with Cerebellar Predominance Presenting as Respiratory Insufficiency and Vocal Cords Paralysis

Mello

Ferreira

Costa

et al. 2010

Case Reports in Medicine

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Background. MSA (Multiple System Atrophy) may be associated either with Parkinsonism or with cerebellar ataxia (MSA-c subtype). It is considered a rare disease, but many patients are misdiagnosed as suffering from idiopathic Parkinson's disease. In this paper, we report a case of a patient admitted with respiratory failure and vocal cords paralysis due to MSA-c. Case Report. A 79-year-old Caucasian woman was admitted in March 2010 with dyspnea, asthenia, stridor, and respiratory failure needing noninvasive ventilation. She had orthostatic blood pressure decline, constipation, insomnia, daytime sleepiness, and snoring. The neurologic examination revealed cerebellar ataxia. A laryngoscopy revealed vocal cord paralysis in midline position and tracheostomy was performed. The Brain Magnetic Resonance Imaging revealed atrophy of middle cerebellar peduncles and pons with the “hot cross bun sign.” Conclusion. Although Multiple-system atrophy is a rare disease, unexplained respiratory failure, bilateral vocal cord paralysis, or stridor should lead to consider MSA as diagnosis.

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Multiple system atrophy as a cause of upper airway obstruction

Cited by 13 publications

References 11 publications

Sacral Reflex Characteristics of Patients with Multiple System Atrophy

Sacral Reflex Characteristics of Patients with Multiple System Atrophy

Laryngeal dystonia in the course of multiple system atrophy: a cause of postoperative respiratory insufficiency

Multiple-System Atrophy with Cerebellar Predominance Presenting as Respiratory Insufficiency and Vocal Cords Paralysis

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