Unilateral vocal cord adductor weakness: an atypical manifestation of motor neurone disease. Issue 2 (11th October 2021)

• Record Type: Journal Article
• Authors: Yogakanthi, Saiumaeswar; Wools, Christine; Mathers, Susan
• Is Part Of: BMJ neurology open. Volume 3:Issue 2(2021)
• Publication Date: 2021-10-11
• Subjects: motor neuron disease -- movement disorders; Neurology -- Periodicals; 616.8
• DOI: 10.1136/bmjno-2021-000205
• Languages: English
• ISSNs: 2632-6140

Abstract

Abstract : Background: Bulbar involvement is a recognised feature of motor neuron disease/amyotrophic lateral sclerosis (MND/ALS), both as a presenting complaint and as a consequence of advancing disease. Hoarseness and dysphonia have been associated with vocal cord abductor weakness. This is usually bilateral and has also been reported as the presenting clinical feature in a handful of patients with superoxide dismutase 1 (SOD1) gene mutations. Presentation with an isolated, unilateral vocal cord adductor weakness, however, is atypical and rare. Case: In this report, we detail the case of a 38-year-old woman with dysphonia and a family history of an SOD1 mutation. Neurological features remained confined to the territory of the left vagus nerve for the next 12 months, before a more rapid rate of disease dissemination and progression. Conclusions: This case highlights the importance of recognition of vocal cord palsy as an early manifestation of MND/ALS and the critical need for monitoring to recognise potential disease progression.