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Korean J Crit Care Med. 2015 May;30(2):123-127. English. Case Report. https://doi.org/10.4266/kjccm.2015.30.2.123
Seo Y , Jeung S , Yoon H , Kim MC , Lee NK , Ghang BZ , Chung SJ , Koh Y .
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. yskoh@amc.seoul.kr
Abstract

A 71-year-old male initially presented with vocal cord palsy and underwent tracheostomy. After thorough examination, urogenital dysfunction, orthostatic hypotension, and Parkinsonism were found, which led to the diagnosis of multiple system atrophy (MSA). After the tracheostomy, bi-level positive airway pressure ventilation was required during the night due to nocturnal hypoxemia. Night-time hypoxemia is related to central sleep apnea, which is one of the manifestations of MSA. This is the first case of MSA manifested by bilateral vocal cord palsy as an initial sign in Korea. This case supports the notion that MSA should be taken into consideration when vocal cord paralysis is observed.

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