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

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.