Stridor and parkinsonism

Read, David; Young, A. W.

doi:10.1136/pgmj.59.694.520

Cited by 9 publications

(4 citation statements)

References 6 publications

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“…More evidence of the effectiveness of antiparkinson medications in ameliorating UAO derives from the observation that acute UAO with stridor and respiratory failure occasionally develops when these medications are manipulated or withdrawn. [17][18][19][20] This is particularly important during the perioperative period or times of critical illness, when the inability to use typical oral medications, such as levodopa, can promote these complications. Intravenous apomorphine has been proposed as a useful intervention in this situation 21 but has limited availability in the United States.…”

Section: Upper Airway Obstructionmentioning

confidence: 99%

Respiratory Complications of Parkinson's Disease

Shill¹,

Stacy²

2002

Seminars in Respiratory and Critical Care Medicine

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Patients with Parkinson's disease are at risk for pulmonary complications as a consequence of both the underlying disease pathology and the side effects of medication. Degeneration of the substantia nigra and subsequent loss of dopaminergic neurons may produce changes in ventilatory parameters. Upper airway obstruction and chest wall restriction are both common, and both may respond to levodopa. However, therapy for Parkinson's may also contribute to pulmonary morbidity. Overtreatment with levodopa causes respiratory dyskinesia that may be difficult to differentiate from complications of the disease itself. Therapy with ergot derivatives may cause pleuropulmonary fibrosis. Pneumonia resulting from the respiratory complications remains a significant cause of morbidity and mortality in Parkinson's disease.

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Section: Upper Airway Obstructionmentioning

confidence: 99%

Respiratory Complications of Parkinson's Disease

Shill¹,

Stacy²

2002

Seminars in Respiratory and Critical Care Medicine

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“…The finding of bilateral VF immobility and respiratory stridor reported here, although rare, is a potentially fatal complication of advanced PD. [ 4 10 12 14 20 21 23 ] Moreover, the potential effects of neuromodulation on VF immobility are largely unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Although a rare finding in patients with PD, the mechanisms for VF immobility in PD may initially stem from rigidity of the intrinsic laryngeal muscles and reduced range of motion of the cricoarytenoid joint. [ 4 5 6 10 12 14 20 23 ] Over time, the reduced range of movement may result in a less flexible and immobile cricoarytenoid joint that further impairs VF mobility, even in the presence of potential benefit from STN-DBS. Therefore, the inability of the VF to open adequately may stem from a combination of muscle rigidity and reduced cricoarytenoid joint mobility.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 5 6 ] Reports of respiratory stridor and vocal fold (VF) immobility in PD are rare but raise important clinical concerns regarding patient care. [ 4 10 12 14 20 21 23 ] The potential effects of DBS on VF immobility remain unknown. We report a case of a PD patient with stridor secondary to bilateral VF immobility ultimately requiring a tracheostomy.…”

Section: Introductionmentioning

confidence: 99%

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Effects of deep brain stimulation on vocal fold immobility in Parkinson's disease

Arocho-Quinones¹,

Hammer²,

Bock³

et al. 2017

Surg Neurol Int

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Background:Vocal fold (VF) immobility is a rare, potentially fatal complication of advanced Parkinson's disease (PD). Previous reports suggest that subthalamic nucleus deep brain stimulation (STN-DBS) may influence laryngeal function, yet the role of STN-DBS on VF immobility remains unexplored.Case Description:We report a case of a patient with advanced PD and bilateral VF immobility ultimately requiring a tracheostomy. To assess the effects of STN-DBS on vocal cord function and to correlate these effects with peripheral motor symptoms at different stimulation settings, the patient was evaluated before and after initiation of bilateral STN-DBS. Measures included direct observation of VF mobility via transnasal laryngoscopy, levodopa equivalent dose of anti-PD medication, and motor scores. High frequency (150 Hz) STN-DBS resulted in improved motor scores, reduced medication requirement, and modestly improved right VF abduction although insufficient for safe decannulation. Low frequency (60 Hz) stimulation resulted in lower motor scores, but without worsening VF abduction.Conclusions:STN-DBS may play an important role in the neuromodulation of PD-induced laryngeal dysfunction, including VF mobility. Characterization of these axial symptoms is important when programming and evaluating responsiveness to DBS.

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Respiratory Dysfunction in Parkinson’s Disease

Shill

2012

Parkinson’s Disease and Nonmotor Dysfunction

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Stridor and parkinsonism

Cited by 9 publications

References 6 publications

Respiratory Complications of Parkinson's Disease

Respiratory Complications of Parkinson's Disease

Effects of deep brain stimulation on vocal fold immobility in Parkinson's disease

Respiratory Dysfunction in Parkinson’s Disease

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