Ramachandra Koushik, Narayana Amruth Reddy, Induraj Anusha, Pai Rohit
Assistant Professor, Department of General Medicine, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India, Corresponding Author, Orcid: https://orcid.org/0000-0003-4483-2725.
Junior Resident, Department of General Medicine, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.
J Assoc Physicians India. 2025 May;73(5):83-84. doi: 10.59556/japi.73.0931.
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative pathology marked by the degeneration of upper and lower motor neurons, resulting in muscle weakness and atrophy, impairing motor function. Bulbar-onset ALS is a distinct clinical subtype, with initial involvement of bulbar motor neurons, often causing severe speech and swallowing difficulties. Despite its impact, bulbar-onset ALS, especially with rare symptoms like unilateral vocal cord palsy (UVCP), lacks extensive research. Here, we detail the case of a 79-year-old nonambulatory diabetic male with a 1-year history of hoarseness of voice, diagnosed with bulbar-onset ALS with UVCP. This underscores the importance of recognizing unusual presentations of ALS, particularly in geriatric populations, urging tailored medical evaluations for optimal care and improved outcomes in this challenging neurological condition.
肌萎缩侧索硬化症（ALS）是一种进行性神经退行性疾病，以上下运动神经元变性为特征，导致肌肉无力和萎缩，损害运动功能。延髓起病型ALS是一种独特的临床亚型，最初累及延髓运动神经元，常导致严重的言语和吞咽困难。尽管有影响，但延髓起病型ALS，尤其是伴有单侧声带麻痹（UVCP）等罕见症状的情况，缺乏广泛研究。在此，我们详细介绍了一名79岁非卧床糖尿病男性患者的病例，该患者有1年声音嘶哑病史，被诊断为伴有UVCP的延髓起病型ALS。这凸显了认识ALS不寻常表现的重要性，尤其是在老年人群中，促使针对这种具有挑战性的神经系统疾病进行量身定制的医学评估，以实现最佳护理和改善预后。
