Annals of Indian Academy of Neurology
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CASE REPORT
Year : 2011  |  Volume : 14  |  Issue : 1  |  Page : 42-43

Vocal cord palsy: An uncommon presenting feature of myasthenia gravis


1 Department of Neurology, Sir Ganga Ram Hospital, New Delhi, India
2 Department of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA
3 Department of Neurology, Saint Vincent's Hospital and Medical Centers, New York, NY, USA
4 Department of Medicine, Saint Vincent's Hospital and Medical Centers, New York, NY, USA

Correspondence Address:
Nitin K Sethi
Comprehensive Epilepsy Center, New York-Presbyterian Hospital, Weill Cornell Medical Center, 525 East, 68th Street, New York, NY 10065
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.78049

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Vocal cord palsy can have myriad causes. Unilateral vocal cord palsy is common and frequently asymptomatic. Trauma, head, neck and mediastinal tumors as well as cerebrovascular accidents have been implicated in causing unilateral vocal cord palsy. Viral neuronitis accounts for most idiopathic cases. Bilateral vocal cord palsy, on the other hand, is much less common and is a potentially life-threatening condition. Myasthenia gravis, an autoimmune disorder caused by antibodies targeting the post-synaptic acetylcholine receptor, has been infrequently implicated in its causation. We report here a case of bilateral vocal cord palsy developing in a 68-year-old man with no prior history of myasthenia gravis 2 months after he was operated on for diverticulitis of the large intestine. Delay in considering the diagnosis led to endotracheal intubation and prolonged mechanical ventilation with attendant complications. Our case adds to the existing literature implicating myasthenia gravis as an infrequent cause of bilateral vocal cord palsy. Our case is unusual as, in our patient, acute-onset respiratory distress and stridor due to bilateral vocal cord palsy was the first manifestation of a myasthenic syndrome.


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