与帕金森病相比，多系统萎缩患者声带运动障碍（VFMI）的患病率和特征。

Prevalence and characterisation of vocal fold motion impairment (VFMI) in patients with Multiple system atrophy compared with Parkinson's disease.

机构信息

Department of Neurology and Movement Disorders APHM Timone, 13005 Marseille, France.

Service de génétique clinique, hôpitaux de Brabois, CHU de Nancy, 54500 Vandœuvre-lès-Nancy, France.

出版信息

Rev Neurol (Paris). 2020 Sep;176(7-8):608-613. doi: 10.1016/j.neurol.2020.01.351. Epub 2020 Mar 10.

DOI:10.1016/j.neurol.2020.01.351

PMID:32164972

Abstract

INTRODUCTION

Multiple system atrophy (MSA) is a neurodegenerative disorder in which vocal fold mobility can be affected, sometimes leading to life-threatening situations. Our aim was to know if laryngeal examination could help differentiate MSA from Parkinson's disease (PD).

MATERIALS AND METHODS

Between 2004 to 2014, all consecutive patients diagnosed with probable MSA were included in this retrospective, monocentric study. Flexible laryngoscopy was obtained in 51 MSA patients and compared with 27 patients with Parkinson's disease (PD). Laryngeal muscles EMG was available in 6 MSA patients.

RESULTS

Vocal fold motion impairments (VFMI) was found in 35 (68.6%) MSA patients: 15 (29.4%) had uni- or bilateral vocal fold abnormal movement (VFAM), 13 (25.5%) had uni- or bilateral vocal fold abductor paresis (VFABP), 4 (7.8%) had uni- or bilateral vocal fold adductor paresis (VFADP), 10 (19.6%) had bilateral vocal fold paralysis (BVFP). VFMI was found in 13 PD patients (48.1%) all of whom had VFADP. Presence of BVFP was found associated with stridor (P<0.001) and dysphagia (P=0.002). In all muscles examined in 6 MSA patients, the EMG showed neuropathic patterns.

CONCLUSIONS

Our data support that VFMI may be encountered in two-thirds of MSA with a variable degree of gravity. Laryngological examination should be considered as a supplementary tool for the diagnosis and prognosis of MSA. VFMI in particular VFAM, VFABD and BVFP should be discussed as an additional possible red flag even at an early stage of MSA and could help discriminate MSA from PD.

摘要

简介

多系统萎缩（MSA）是一种神经退行性疾病，其声带活动可能会受到影响，有时会导致危及生命的情况。我们的目的是了解喉部检查是否有助于将 MSA 与帕金森病（PD）区分开来。

材料和方法

在 2004 年至 2014 年期间，我们纳入了所有确诊为可能 MSA 的连续患者进行回顾性单中心研究。对 51 例 MSA 患者进行了软性喉镜检查，并与 27 例帕金森病（PD）患者进行了比较。6 例 MSA 患者可进行喉肌肌电图检查。

结果

35 例（68.6%）MSA 患者存在声带运动障碍（VFMI）：15 例（29.4%）存在单侧或双侧声带异常运动（VFAM），13 例（25.5%）存在单侧或双侧声带外展肌瘫痪（VFABP），4 例（7.8%）存在单侧或双侧声带内收肌瘫痪（VFADP），10 例（19.6%）存在双侧声带瘫痪（BVFP）。13 例 PD 患者（48.1%）存在 VFMI，均为 VFADP。发现双侧声带瘫痪与喘鸣（P<0.001）和吞咽困难（P=0.002）有关。在 6 例 MSA 患者检查的所有肌肉中，肌电图显示神经病变模式。