Stridor and death in multiple system atrophy

Silber, Michael H.; Levine, Samantha

doi:10.1002/1531-8257(200007)15:4<699::aid-mds1015>3.0.co;2-l

Cited by 205 publications

(122 citation statements)

References 22 publications

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“…There are a few recent reports on RBD associated with spinocerebellar atrophy type 3 (Machado-Joseph disease). [63][64][65] As noted above, numerous cases of RBD have been reported in conjunction with MSA, 3,22,23,27,[66][67][68][69][70][71][72] PD, 3,11,22,[24][25][26][27][30][31][32][33][34][35]73 and DLB. 1,10,15,41,45,[47][48][49][50][51][52][53]55,59,60,74 Although frequency data on the presence of RSWA and RBD in the neurodegenerative disorders is based on relatively small numbers of patients thus far, the presence of each in MSA has been reported to be 90% to 95% for RSWA and 68% to 90% for RBD, 66,67 and presence of each in PD is approximately 58% for RSWA and 33% for RBD.…”

Section: The Rbd-synucleinopathy Associationmentioning

confidence: 99%

REM Sleep Behavior Disorder in Parkinson’s Disease and Dementia with Lewy Bodies

Boeve

Silber

Ferman

2004

J Geriatr Psychiatry Neurol

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207

106

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Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia manifested by vivid, often frightening dreams associated with simple or complex motor behavior during REM sleep. Patients appear to "act out their dreams," in which the exhibited behaviors mirror the content of the dreams. Management of RBD involves counseling about safety measures in the sleep environment; in those at risk for injury, clonazepam and/or melatonin is usually effective. In this article, the authors present a detailed review of the clinical and polysomnographic features, differential diagnosis, diagnostic criteria, management strategies, and pathophysiologic mechanisms of RBD. They then review the literature and their institutional experience of RBD associated with neurodegenerative disease, particularly Parkinson's disease and dementia with Lewy bodies. The evolving data suggests that RBD may have clinical diagnostic and pathophysiologic significance in isolation and when associated with neurodegenerative disease. (J Geriatr Psychiatry Neurol 2004; 17:146-157)

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Section: The Rbd-synucleinopathy Associationmentioning

confidence: 99%

REM Sleep Behavior Disorder in Parkinson’s Disease and Dementia with Lewy Bodies

Boeve

Silber

Ferman

2004

J Geriatr Psychiatry Neurol

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207

106

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“…Parkinsonism is defined by the presence of two of three symptoms, including rigidity, tremor, and hypokinesia. The most common atypical form of parkinsonism, multiple system atrophy (MSA), is a relentlessly progressive neurodegenerative disorder characterized by neuronal cell loss and gliosis in specific areas of the brain, causing various combinations of systemic degeneration [3,4]. Although it is well known that these two disease entities have different underlying mechanisms, including studies of potential causal factors, differential diagnosis of parkinsonian disorders on the basis of clinical signs and symptoms is still difficult due to overlapping symptomatology.…”

Section: Introductionmentioning

confidence: 99%

Polyamine patterns in the cerebrospinal fluid of patients with Parkinson's disease and multiple system atrophy

Paik¹,

Ahn²,

Lee³

et al. 2010

Clinica Chimica Acta

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“…Cases of sudden death during sleep have still been reported following treatment with either nasal CPAP or tracheostomy, suggesting that other mechanisms of autonomic dysfunction may still be fatal in MSA. 4,6 RBD and REM sleep without atonia characterized by especially prominent excessive tonic muscle activity are frequent in MSA. Melatonin or clonazepam may be offered as therapies, with melatonin preferred to avoid exacerbating SDB and neurological dysfunction.…”

Section: -4mentioning

confidence: 99%

A 76 Year-Old Woman with Sleep and Waking Stridor, Sleep Talking, Orthostatic Hypotension, and Imbalance

Louis

Duwell

Orbelo

et al. 2016

Journal of Clinical Sleep Medicine

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A 76-year-old woman presented with a three-month history of a harsh, high-pitched breathing noise during sleep, which had also recently begun to occur occasionally during the daytime while awake. Sleep talking had been noted for decades but recently had become louder and more agitated in character. No other nocturnal motor activity was noted. Over the last year, she had intermittent urinary urgency and incontinence; softer, imprecise speech; imbalance; and dizziness while standing, with severe supine hypertension. Midodrine was unhelpful. Her only medication was losartan 25 mg daily.On examination, there was moderate hypomimia, hypokinetic dysarthria, inspiratory and phonatory stridor (Video 1), moderate symmetric rigidity and bradykinesia, and a 30-mm systolic blood pressure drop from sitting to standing. Also noted was loud waking stridor, particularly notable during inspiration, with use of accessory respiratory muscles (sternocleidomastoid and neck strap muscles) indicating increased effort as the patient breathes against dysfunctional vocal cords (Video 1).Videolaryngoscopy showed significantly reduced vocal fold mobility bilaterally, with failure of abduction and paradoxical movement of true vocal fold tissue during inspiration. Autonomic reflex screen demonstrated severe orthostatic hypotension during head-up tilt table testing, and marked cardiovagal, cardiovascular adrenergic, and patchy postganglionic sympathetic sudomotor abnormalities. Thermoregulatory sweat testing demonstrated severe anhidrosis compatible with central autonomic failure. Brain MRI showed linear hyperintensities along the lateral aspects of the putamen (Figure 1)

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Stridor and death in multiple system atrophy

Cited by 205 publications

References 22 publications

REM Sleep Behavior Disorder in Parkinson’s Disease and Dementia with Lewy Bodies

REM Sleep Behavior Disorder in Parkinson’s Disease and Dementia with Lewy Bodies

Polyamine patterns in the cerebrospinal fluid of patients with Parkinson's disease and multiple system atrophy

A 76 Year-Old Woman with Sleep and Waking Stridor, Sleep Talking, Orthostatic Hypotension, and Imbalance

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