Department of Anaesthesiology and Intensive Therapy, Medical University of Gdańsk, Ul. Dębinki 7, 80-211, Gdańsk, Poland.
Neurol Sci. 2012 Jun;33(3):681-3. doi: 10.1007/s10072-011-0840-9. Epub 2011 Nov 6.
Multiple system atrophy (MSA) is an adult onset, incurable neurodegenerative disease, characterized by symptoms of nervous system failure. Occurrence of laryngeal dystonia indicates increased risk of sudden death caused by airway occlusion. We present the case report of 63-year-old patient with history of orthostatic hypotension, parkinsonism, progressive adynamia, and stridor. The patient was admitted to the hospital for diagnosis of orthostatic hypotension. A diagnosis of possible MSA was made. Because of patient's complaints, an X-ray of the hip joint was taken. It revealed femoral neck fracture. Endoprosthesis insertion under general anesthesia was performed. Two days later the patient presented progressive adynamy and respiratory insufficiency. Endotracheal intubation and respiratory support were required followed by extubation and one more intubation. After second extubation, stridor and acute respiratory insufficiency occurred. Urgent tracheostomy was performed. After 13 days in ICU, the patient was discharged to the rehabilitation center.
多系统萎缩（MSA）是一种成年起病、无法治愈的神经退行性疾病，其特征为神经系统衰竭的症状。发生喉部痉挛提示气道阻塞导致突然死亡的风险增加。我们报告了一例 63 岁患者的病例，该患者有直立性低血压、帕金森病、进行性无力和喘鸣的病史。患者因直立性低血压而住院诊断。可能的 MSA 诊断。由于患者的抱怨，对髋关节进行了 X 光检查。结果显示股骨颈骨折。在全身麻醉下进行了内置假体插入。两天后，患者出现进行性无力和呼吸功能不全。需要进行气管插管和呼吸支持，随后进行了一次拔管和再次插管。第二次拔管后，出现喘鸣和急性呼吸功能不全。紧急进行了气管切开术。在 ICU 治疗 13 天后，患者出院到康复中心。
