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• Vol.47 No.6
• CLINICA NEUROL, 47: 340−343, 2007
• Vol.47 No.6 contents

Case Report

A pathological study on abducent paralysis of the vocal cord found in a patient of multiple system atrophy with nasogastric intubation

Tomoyuki Nagata, M.D., Hiroyuki Kamei, M.D.*, Kazuhiro Furuya, M.D., Naoki Fujii, M.D., Kazuhito Noda, M.D.** and Toru Iwaki, M.D.**

Department of Neurology, Neuro-Musclar Center, National Omuta Hospital
*Yoshizuka Hayashi Hospital
**Department of Neuropathology, Neurological Institute Graduate School of Medical Sciences, Kyusyu University

A 74-year-old man developed instability of gait from age 64, difficulty in writing from age 66 and dysarthria-hypohidrosis from around age 67. These symptoms progressed slowly accompanied with orthostatic hypotension and dysarthria, which decline his ADL. At age 71, he was admitted to our hospital and underwent nasogastric intubation. After admission, he also showed the decrease in his voluntary activities, accidental ingestion and loud snoring during sleep. He died of accidental aspiration pneumonia at age 74. Postmortem examination revealed severe pathological changes as multiple system atrophy (MSA) in the central nervous system. There was a small ulcer in the hypopharyngeal region, and acute inflammation of the ulcer came down to the posterior cricoarytenoid muscle. Combined with severe neurogenic atropy due to MSA, local inflammation of the ulcer associated with nasogastric intubation appeared to have resulted in severe damage of the posterior cricoarytenoid muscle.

(CLINICA NEUROL, 47: 340−343, 2007)
key words: multiple system atrophy, vocal paralysis, nasogastric tube syndrome

(Received: 16-Dec-06)