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Stridor and death in multiple system atrophy.

M H Silber1, S Levine

  • 1Mayo Sleep Disorders Center, Mayo Clinic, Rochester, Minnesota 55905, USA.

Movement Disorders : Official Journal of the Movement Disorder Society
|August 6, 2000
PubMed
Summary
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Stridor in multiple system atrophy (MSA) patients indicates a poorer prognosis, significantly reducing survival time post-diagnosis. Assessment for central hypoventilation and considering tracheostomy are recommended for these patients.

Area of Science:

  • Neurology
  • Sleep Medicine
  • Pulmonology

Background:

  • Multiple system atrophy (MSA) is a neurodegenerative disorder with a typical survival of 8-10 years.
  • Nocturnal stridor is a symptom that has been anecdotally linked to a worse prognosis in MSA patients.

Purpose of the Study:

  • To investigate the prognostic significance of stridor in patients with multiple system atrophy.
  • To analyze the impact of stridor on survival rates in MSA patients.

Main Methods:

  • Retrospective analysis of demographic, clinical, and polysomnographic data from 42 MSA patients.
  • Survival data was collected for 30 patients, comparing those with and without stridor.
  • Stridor was categorized as nocturnal or daytime, with vocal cord mobility also assessed.

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Main Results:

  • Patients with stridor had significantly shorter survival times from sleep evaluation compared to non-stridor patients.
  • Nine of 11 stridor patients died within a median of 2 years; survivors had undergone tracheostomy.
  • Daytime stridor with immobile vocal cords indicated a particularly poor prognosis, though tracheostomy did not guarantee survival.

Conclusions:

  • Stridor is a significant indicator of poor prognosis in multiple system atrophy patients.
  • Central hypoventilation may contribute to mortality in MSA patients, necessitating assessment and management.
  • Tracheostomy is a potential intervention for stridor in MSA, but other causes of death must be considered.