Adult-onset familial vocal fold paralysis

We describe the cases of 2 brothers in their early 50s, born to consanguineous parents, who presented with acute stridor as a result of adult-onset bilateral abductor vocal fold paralysis. Both patients had a history of adult-onset asthma. No other associated symptoms were evident, and findings on neurologic examination and all other investigations were normal. Both patients required emergency surgical tracheostomy. Another brother with a similar history had died of an airway problem when he was 53 years of age; 2 other younger brothers and 3 younger sisters were currently unaffected. To the best of our knowledge, this is the first report of adult-onset familial bilateral vocal fold paralysis in the absence of associated features. The parents' consanguinity suggested an autosomal recessive basis to this disorder. In addition to describing the features of this case, we review the literature relating to adult-onset familial vocal fold paralysis.