Childhood Laryngeal Dystonia Following Bilateral Globus Pallidus Abnormality: A Case Study and Review of Literature

Document Type : Case Report

Authors

1 Department of Anatomical Sciences and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Department of Neurology, Iran University of Medical Sciences, Tehran, Iran.

Abstract

Introduction:
Dystonia is a disorder of movement caused by various etiologies. Laryngeal dystonia is caused by the spasm of laryngeal muscles. It is a disorder caused by vocal fold movement in which excessive adduction or abduction of the vocal folds occurs during speech. The pathophysiology of this type of dystonia is not fully known. Some researchers have suggested that basal ganglia structures and their connections with cortical areas have been involved in the pathogenesis of dystonia.
 Case Report:
In this paper a 7.5-year-old boy suffering from laryngeal dystonia with bilateral lesions in Globus Pallidus is presented. The patient also suffered from swallowing problems, monotone voice, vocal tremor, hypersensitivity of gag reflex, and stuttering. Drug treatment failed to cure him; therefore, he was referred to rehabilitation therapy. 
 Conclusion:
In conclusion, special attention should be brought upon laryngeal dystonia, especially in patients showing Extra-pyramidal symptoms and/or abnormalities of the basal ganglia. In children, laryngeal dystonia may be potentially fatal. Lack of consideration for this condition during rehabilitation therapy can lead to serious consequences for a child.
 
 

Keywords

Main Subjects

Full Text

1. Payne S, Tisch S, Cole I, Brake H, Rough J, Darveniza P. The clinical spectrum of laryngeal dystonia includes dystonic cough: Observations of a large series. Movement Disorders. 2014;29(6):729-35.

2. Hood S, Orr K, Bennett L, Davies S. Severe laryngeal dystonia in a patient receiving zuclopenthixol “Acuphase” and fluoxetine. Australasian Psychiatry. 2010;18(2):174-6.

3. Sari A, Taskapilioglu O, Akkaya C, Erer S, Bora I. Laryngeal dystonia in a patient with bilateral anterior cerebral artery infarction during treatment of delirium with haloperidol. Progress in Neuro-Psychopharma- cology and Biological Psychiatry.2008; 32(5):1347-8.

4. Ludlow CL, Adler CH, Berke GS, Bielamowicz SA, Blitzer A, Bressman SB, et al. Research priorities in spasmodic dysphonia. Otolaryngology-Head and Neck Surgery. 2008;139(4):495-505.

5. Castelon Konkiewitz E, Trender-Gerhard I, Kamm C, Warner T, Ben-Shlomo Y, Gasser T, et al. Service-based survey of dystonia in Munich. Neuroepide- miology. 2002;21(4):202-6.

6. Borujeni MJS, Esfandiary E, DOOGHAEE MA. Childhood Neurogenic Stuttering Due to Bilateral Congenital Abnormality in Globus Pallidus: A Case Report and Review of the Literature. Iranian Journal of Child Neurology. 2016;10(4):75-9.

7. Hegde AN, Mohan S, Lath N, Lim CT. Differential Diagnosis for Bilateral Abnormalities of the Basal Ganglia and Thalamus 1. Radiographics. 2011; 31(1): 5-30.

8. Lim C. Magnetic resonance imaging findings in bilateral basal ganglia lesions. Ann Acad Med Singapore. 2009;38(9):795-8.

9. Walter U, Blitzer A, Benecke R, Grossmann A, Dressler D. Sonographic detection of basal ganglia abnormalities in spasmodic dysphonia. European Journal of Neurology. 2014;21(2):349-52.

10. Simonyan K, Berman BD, Herscovitch P, Hallett M. Abnormal striatal dopaminergic neurotransmission during rest and task production in spasmodic dysphonia. The Journal of Neuroscience. 2013; 33 (37): 14705-14.

11. Simonyan K, Ludlow CL. Abnormal activation of the primary somatosensory cortex in spasmodic dysphonia: an fMRI study. Cerebral Cortex. 2010; 20: 2749-59.

12. Simonyan K, Tovar-Moll F, Ostuni J, Hallett M, Kalasinsky VF, Lewin-Smith MR, et al. Focal white matter changes in spasmodic dysphonia: a combined diffusion tensor imaging and neuropathological study. Brain. 2008;131(2):447-59.

13. Hayflick SJ. Unraveling the Hallervorden-Spatz syndrome: pantothenate kinase–associated neurodege- neration is the name. Current opinion in pediatrics. 2003;15(6):572-7.

14. Blitzer A. Spasmodic dysphonia and botulinum toxin: experience from the largest treatment series. European Journal of Neurology. 2010;17(s1):28-30.

15. Hamano K, Kumada S, Hayashi M, Naito R, Hayashida T, Uchiyama A, et al. Laryngeal dystonia in a case of severe motor and intellectual disabilities due to Japanese encephalitis sequelae. Brain and Development. 2004;26(5):335-8.

16. Mellacheruvu S, Norton JW, Schweinfurth J. Atypical antipsychotic drug-induced acute laryngeal dystonia: 2 case reports. Journal of clinical psychopharmacology. 2007;27(2):206-7.

17. Conte A, Berardelli I, Ferrazzano G, Pasquini M, Berardelli A, Fabbrini G. Non-motor symptoms in patients with adult-onset focal dystonia: sensory and psychiatric disturbances. Parkinsonism & Related Disorders. 2016; 22:S111-S4.

18.Stamelou M, Edwards MJ, Hallett M, Bhatia KP. The non-motor syndrome of primary dystonia: clinical and pathophysiological implications. Brain. 2012;135(6):1668-81.

19. Russell SA, Hennes HM, Herson KJ, Stremski ES. Upper airway compromise in acute chlorpromazine ingestion. The American journal of emergency medicine. 1996;14(5):467-8.

20. Miyata R, Sasaki T, Hayashi M, Araki S, Shimohira M, Kohyama J. Low-dose levodopa is effective for laryngeal dystonia in xeroderma pigmentosum group A. Brain and Development. 2010;32(8):685-7.

References

  1. Payne S, Tisch S, Cole I, Brake H, Rough J, Darveniza P. The clinical spectrum of laryngeal dystonia includes dystonic cough: Observations of a large series. Movement Disorders. 2014;29(6):729-35.
  2. Hood S, Orr K, Bennett L, Davies S. Severe laryngeal dystonia in a patient receiving zuclopenthixol “Acuphase” and fluoxetine. Australasian Psychiatry. 2010;18(2):174-6.
  3. Sari A, Taskapilioglu O, Akkaya C, Erer S, Bora I. Laryngeal dystonia in a patient with bilateral anterior cerebral artery infarction during treatment of delirium with haloperidol. Progress in Neuro-Psychopharma- cology and Biological Psychiatry.2008; 32(5):1347-8.
  4. Ludlow CL, Adler CH, Berke GS, Bielamowicz SA, Blitzer A, Bressman SB, et al. Research priorities in spasmodic dysphonia. Otolaryngology-Head and Neck Surgery. 2008;139(4):495-505.
  5. Castelon Konkiewitz E, Trender-Gerhard I, Kamm C, Warner T, Ben-Shlomo Y, Gasser T, et al. Service-based survey of dystonia in Munich. Neuroepide- miology. 2002;21(4):202-6.
  6. Borujeni MJS, Esfandiary E, DOOGHAEE MA. Childhood Neurogenic Stuttering Due to Bilateral Congenital Abnormality in Globus Pallidus: A Case Report and Review of the Literature. Iranian Journal of Child Neurology. 2016;10(4):75-9.
  7. Hegde AN, Mohan S, Lath N, Lim CT. Differential Diagnosis for Bilateral Abnormalities of the Basal Ganglia and Thalamus 1. Radiographics. 2011; 31(1): 5-30.
  8. Lim C. Magnetic resonance imaging findings in bilateral basal ganglia lesions. Ann Acad Med Singapore. 2009;38(9):795-8.
  9. Walter U, Blitzer A, Benecke R, Grossmann A, Dressler D. Sonographic detection of basal ganglia abnormalities in spasmodic dysphonia. European Journal of Neurology. 2014;21(2):349-52.
  10. Simonyan K, Berman BD, Herscovitch P, Hallett M. Abnormal striatal dopaminergic neurotransmission during rest and task production in spasmodic dysphonia. The Journal of Neuroscience. 2013; 33 (37): 14705-14.
  11. Simonyan K, Ludlow CL. Abnormal activation of the primary somatosensory cortex in spasmodic dysphonia: an fMRI study. Cerebral Cortex. 2010; 20: 2749-59.
  12. Simonyan K, Tovar-Moll F, Ostuni J, Hallett M, Kalasinsky VF, Lewin-Smith MR, et al. Focal white matter changes in spasmodic dysphonia: a combined diffusion tensor imaging and neuropathological study. Brain. 2008;131(2):447-59.
  13. Hayflick SJ. Unraveling the Hallervorden-Spatz syndrome: pantothenate kinase–associated neurodege- neration is the name. Current opinion in pediatrics. 2003;15(6):572-7.
  14. Blitzer A. Spasmodic dysphonia and botulinum toxin: experience from the largest treatment series. European Journal of Neurology. 2010;17(s1):28-30.
  15. Hamano K, Kumada S, Hayashi M, Naito R, Hayashida T, Uchiyama A, et al. Laryngeal dystonia in a case of severe motor and intellectual disabilities due to Japanese encephalitis sequelae. Brain and Development. 2004;26(5):335-8.
  16. Mellacheruvu S, Norton JW, Schweinfurth J. Atypical antipsychotic drug-induced acute laryngeal dystonia: 2 case reports. Journal of clinical psychopharmacology. 2007;27(2):206-7.
  17. Conte A, Berardelli I, Ferrazzano G, Pasquini M, Berardelli A, Fabbrini G. Non-motor symptoms in patients with adult-onset focal dystonia: sensory and psychiatric disturbances. Parkinsonism & Related Disorders. 2016; 22:S111-S4.
  18. Stamelou M, Edwards MJ, Hallett M, Bhatia KP. The non-motor syndrome of primary dystonia: clinical and pathophysiological implications. Brain. 2012;135(6):1668-81.
  19. Russell SA, Hennes HM, Herson KJ, Stremski ES. Upper airway compromise in acute chlorpromazine ingestion. The American journal of emergency medicine. 1996;14(5):467-8.
  20. Miyata R, Sasaki T, Hayashi M, Araki S, Shimohira M, Kohyama J. Low-dose levodopa is effective for laryngeal dystonia in xeroderma pigmentosum group A. Brain and Development. 2010;32(8):685-7.

 

 

 

 

 

Iranian Journal of Otorhinolaryngology
Volume 29, Issue 1
January and February 2017
Pages 47-51

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