Abductor Paresis in Shy–Drager Disease

  • Eiji IsozakiEmail author
Part of the Current Clinical Neurology book series (CCNEU)


Vocal cord abductor paralysis (VCAP) is one of the life-threatening ­complications in multiple system atrophy. We proposed the mechanism as a multifactorial process, involving paralytic, nonparalytic, and enhancing factors. VCAP is diagnosed by both clinical features, including nocturnal inspiratory stridor with severe oxygen desaturation, and laryngofiberscopic examination showing paradoxical vocal cord movement. While a tracheostomy has been exclusively applied for VCAP in the past, noninvasive positive pressure ventilation has recently been used with some effectiveness. Of clinical importance is that the upper airway obstructions caused by the supraglottic tissues such as floppy epiglottis and floppy arytenoid are unresponsive to noninvasive positive pressure ventilation.


Vocal Cord Multiple System Atrophy Central Sleep Apnea Noninvasive Positive Pressure Ventilation Multiple System Atrophy Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Tokyo Metropolitan Institute for NeuroscienceFuchuJapan
  2. 2.Department of NeurologyTokyo Metropolitan Neurological HospitalTokyoJapan

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