A Rare Presentation of Bilateral Vocal Cord Paralysis in Late Stage Parkinson’s Disease

Introduction: Vocal cord paralysis often causes mortality by upper airway obstruction in some neurodegenerative diseases such as Parkinson’s disease and multiple system atrophy. Vocal cord paralysis is uncommon in Parkinson’s disease (PD) on the contrary it is more common in multiple system atrophy (MSA). The pathogenesis of vocal cord paralysis in Parkinson’s disease is not well understood but may involve degeneration of the nucleus ambiguous. In terms of managing patients with bilateral vocal cord paralysis in PD, it can either perform a tracheostomy to relieve the upper airway obstruction or optimize the medical treatment. There are very few available reported cases whereby patients are treated with medical treatment alone.Case Report: We report a case of 65 years old lady who presented with stridor resulting from bilateral vocal cord paralysis and has been diagnosed with Parkinson’s disease for more than 10 years. She had her antiparkinson medication optimized and requiring no surgical intervention to relieve the upper airway obstruction.Conclusion: In conclusion, we would like to emphasize that it is important to recognize bilateral vocal cord paralysis in Parkinson’s disease and early optimization of medical treatment could avoid a need for tracheostomy.