RESEARCH: Dystonia causes stridor in multiple system atrophy.

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Neurology 2002 Feb 26;58(4):649-52

Not paralysis, but dystonia causes stridor in multiple

system atrophy.

Merlo IM, Occhini A, Pacchetti C, Alfonsi E.

Spinal and Cranial Reflexes Laboratory (Drs. Merlo and

Alfonsi), and Movement Disorders and Parkinson's

Disease Unit (Dr. Pacchetti), Istituto Neurologico C.

Mondino I.R.C.C.S., Universita di Pavia.

Electromyography (EMG) was performed in 10 patients

with multiple system atrophy, laryngeal or pharyngeal

symptoms, or both. In patients with stridor, EMG

during quiet breathing revealed persistent tonic

activity in both abductor and adductor vocal cord

muscles. In patients with dysphagia, the

cricopharyngeal muscle showed persistent EMG activity

throughout all phases of swallowing. Botulinum toxin

injection into the adductor muscle determined

subjective improvement and reduced tonic EMG activity.

Therefore, the cause of stridor in multiple system

atrophy is dystonia of the vocal cords.

PMID: 11865150 [PubMed - in process]

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