1/12. vocal cord paralysis in the shy-drager syndrome. A cause of postoperative respiratory obstruction.A case is presented in which unexpected and persistent postoperative respiratory problems led to the finding of bilateral abductor vocal cord paralysis and confirmed the diagnosis of the shy-drager syndrome. Anaesthetists should be aware that vocal cord paralysis may be a feature of this uncommon condition, and should consider the possibility of glottic obstruction as a cause of ventilatory difficulties.- - - - - - - - - - ranking = 1keywords = paralysis (Clic here for more details about this article) |
2/12. snoring as a presenting feature of the shy-drager syndrome.A 67-year-old man with a progressive snoring habit is presented. Fluctuant bilateral abductor vocal cord paralysis was later recognized together with autonomic features suggesting a diagnosis of shy-drager syndrome. snoring as a presenting feature of this condition has been infrequently described. This case highlights the importance of careful assessment of snorers.- - - - - - - - - - ranking = 0.16666666666667keywords = paralysis (Clic here for more details about this article) |
3/12. vocal cord paralysis as a presenting sign in the shy-drager syndrome.A 70-year-old patient with bilateral vocal cord paralysis, accompanied by inspiratory stridor and increased snoring, is presented. Respiratory dysfunction, deteriorating over 18 months, necessitated permanent tracheostomy. Only two and a half years after the onset of symptoms the patient developed extrapyramidal signs combined with severe autonomic failure, suggesting a diagnosis of shy-drager syndrome. Vocal cord palsy preceding any other neurological or autonomic manifestations of that syndrome has been infrequently described. This diagnosis should be considered in cases of vocal cord palsy of undetermined etiology, especially when associated with increased snoring or episodes of sleep apnea.- - - - - - - - - - ranking = 0.84179018182516keywords = paralysis, palsy (Clic here for more details about this article) |
4/12. The posterior crico-arytenoid muscle in two cases of shy-drager syndrome with laryngeal stridor. Comparison of the histological, histochemical and biometric findings.The histological, histochemical and biometric findings in the posterior crico-arytenoid muscle in two patients with shy-drager syndrome were compared with those found in cases of carcinoma of the larynx. In biopsy specimens from the patients with laryngeal carcinoma, neurogenic atrophy and various structural changes in the muscle fibres were the prominent features. In the two patients with shy-drager syndrome these changes were not present and the only significant finding was the more pronounced type I fibre atrophy, with type II fibre predominance in the more severely affected case. These findings do not permit the vocal cord paralysis seen in the shy-drager syndrome to be explained by motorneuron loss and denervation. It is postulated that a possible cause may be a biochemical defect in the brain.- - - - - - - - - - ranking = 0.16666666666667keywords = paralysis (Clic here for more details about this article) |
5/12. Bilateral vocal cord paralysis in shy-drager syndrome.A patient with a permanent tracheostomy was seen and noted to have bilateral abductor vocal cord paralysis. He was being investigated neurologically and was found to have several types of autonomic failure, specifically including postural hypotension. It was felt that he had shy-drager syndrome. A review of the literature showed that bilateral vocal cord paralysis is a recognized abnormality in this condition for which permanent speaking tracheostomy is the treatment of choice. Reflux esophagitis due to lax cardiac sphincter may be a factor in the laryngeal symptomatology.- - - - - - - - - - ranking = 1keywords = paralysis (Clic here for more details about this article) |
6/12. ketamine anaesthesia for a patient with the shy-drager syndrome.A 58-year-old man with the shy-drager syndrome underwent laryngo- and tracheoscopies in general anaesthesia for evaluation of the larynx after tracheostomy following bilateral vocal cord paralysis. A profound fall in arterial pressure during anaesthesia induced with thiopentone has been demonstrated in previously reported patients with the shy-drager syndrome. In the present patient, anaesthesia induced with ketamine, maintained with nitrous oxide in oxygen and supplemented with fentanyl, diazepam and suxamethonium did not cause a fall in arterial pressure.- - - - - - - - - - ranking = 0.16666666666667keywords = paralysis (Clic here for more details about this article) |
7/12. Laryngeal abductor paralysis in multiple system atrophy. A report on three necropsied cases, with observations on the laryngeal muscles and the nuclei ambigui.Clinical and pathological findings are reported in three cases of shy-drager syndrome with laryngeal stridor severe enough to require tracheostomy. Indirect laryngoscopy in all three cases revealed a failure to abduct the vocal cords properly with a resulting narrowing of the glottic airway. Histological studies showed a marked atrophy of the posterior crico-arytenoid muscles and little atrophy of the other laryngeal muscles. The posterior crico-arytenoid muscles have the sole responsibility of abducting the vocal cords, so it is concluded that the patient's stridor was caused by the selective paralysis of these muscles. Histological studies of the posterior crico-arytenoid muscles were suggestive of denervation but despite this finding, no clear evidence of any motor cell loss in the nuclei ambigui was obtained. Other possible causes of the selective posterior crico-arytenoid atrophy are discussed.- - - - - - - - - - ranking = 0.83333333333333keywords = paralysis (Clic here for more details about this article) |
8/12. Bilateral vocal cord paralysis with shy-drager syndrome.shy-drager syndrome consists of progressive autonomic nervous system failure with Parkinson's disease-like symptoms and orthostatic hypotension. It can also result in airway compromise from bilateral vocal cord paralysis. Fewer than 30 cases of severe bilateral vocal cord paresis or paralysis associated with the shy-drager syndrome have been reported in the English literature. We present a case of a 72-year-old man who had a 2-year history of orthostatic hypotension, neurogenic bladder, impotence, anhydrosis, and extremity weakness and paresthesias. hoarseness and dyspnea with stridor developed as a result of bilateral vocal cord paralysis in the median position and required an emergency tracheotomy. This combination of symptoms resulted in the diagnosis of shy-drager syndrome. We present the case along with literature review of bilateral vocal cord paralysis with the shy-drager syndrome.- - - - - - - - - - ranking = 1.3333333333333keywords = paralysis (Clic here for more details about this article) |
9/12. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and Gerhardt syndrome associated with shy-drager syndrome.This is the first report on a case of syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with Gerhardt syndrome (paralysis of bilateral vocal cords). A 67-year-old Japanese man suffering from progressive autonomic failure was diagnosed as having shy-drager syndrome (SDS) with hyponatremia due to SIADH and severe sleep apnea caused by a bilateral recurrent nerve palsy. water load test showed alteration in diuresis which was corrected by phenytoin. arginine vasopressin secretion was not suppressed by plasma osmolality below 280 mOsm/kgH2O. Impairment of the afferent pathways of baroreceptors, or impairment of the osmoreceptors could be speculated as the etiological factor of the SIADH observed in this case.- - - - - - - - - - ranking = 0.17089509091258keywords = paralysis, palsy (Clic here for more details about this article) |
10/12. shy-drager syndrome presenting as Meniere's disease.A 59-year-old patient with a history of Meniere's disease is presented. She developed signs of progressive autonomic failure suggesting a diagnosis of shy-drager syndrome, a rare degenerative neurologic condition of unknown etiology. The most common otolaryngologic presentation of this syndrome is with stridor attributable to abductor paralysis of the vocal cords. The association with endolymphatic hydrops has not been previously described.- - - - - - - - - - ranking = 0.16666666666667keywords = paralysis (Clic here for more details about this article) |
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