Objective: To clarify the clinical features of Parkinson’s disease patients who developed stridor with acute respiratory failure due to vocal cord paralysis or laryngeal dystonia.

Background: It is widely known that stridor is commonly seen in patients with multiple system atrophy (MSA) and related with poor prognosis and sudden death. Although stridor is rare in Parkinson’s disease (PD) patients, it is an important symptom because it may lead to acute respiratory failure and sudden death. Therefore, it would be helpful to elucidate the characteristics of PD patients at risk.

Methods: We retrospectively reviewed the clinical record of our hospital and searched for PD patients who developed stridor with acute respiratory failure. The clinical data were collected with the characteristics of stridor.

Results: Here we present some illustrative cases identified in our record. Case 1. A 75 year-old man who had a 24-year history of PD developed acute dyspnea with difficulty in both inspiratory and expiratory breathing during his admission to our hospital. He had been suffered from severe dysphagia and vomiting one month and a half prior to this episode. He was transferred to the emergency department of another hospital, where vocal cord palsy and laryngeal dystonia were disclosed by laryngoscopy. As the laryngeal dystonia occurred every five minutes, tracheal intubation was needed, followed by tracheostomy. Case 2. A 70 year-old woman with young-onset PD started at the age of 32 years was admitted to our hospital, because dysphagia had worsened. Inspiratory nocturnal stridor was noted only for a short period after her admission, but in the morning of ninth hospital day, inspiratory stridor worsened. She was transferred to another hospital and tracheostomy was performed. Case 3. A 64 year-old PD patient with the disease duration of 15 years developed inspiratory stridor with acute respiratory failure. As the stridor continued even after admission to our hospital, tracheostomy was done on the same day. He had dysphagia four years before this episode.

Conclusions: Although rare, some cases of PD who developed stridor were found in our hospital record. The cases presented here had long duration of PD ranging from 15 to 38 years and the history of dysphagia before developing stridor. Other clinical features and the problem of the differential diagnosis from other related disorders will also be discussed.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-features-of-parkinsons-disease-patients-developing-stridor-with-acute-respiratory-failure/