RT Journal Article
SR Electronic
T1 Stridor in multiple system atrophy
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 630
OP 639
DO 10.1212/WNL.0000000000008208
VO 93
IS 14
A1 Cortelli, Pietro
A1 Calandra-Buonaura, Giovanna
A1 Benarroch, Eduardo E.
A1 Giannini, Giulia
A1 Iranzo, Alex
A1 Low, Phillip A.
A1 Martinelli, Paolo
A1 Provini, Federica
A1 Quinn, Niall
A1 Tolosa, Eduardo
A1 Wenning, Gregor K.
A1 Abbruzzese, Giovanni
A1 Bower, Pamela
A1 Alfonsi, Enrico
A1 Ghorayeb, Imad
A1 Ozawa, Tetsutaro
A1 Pacchetti, Claudio
A1 Pozzi, Nicolò Gabriele
A1 Vicini, Claudio
A1 Antonini, Angelo
A1 Bhatia, Kailash P.
A1 Bonavita, Jacopo
A1 Kaufmann, Horacio
A1 Pellecchia, Maria Teresa
A1 Pizzorni, Nicole
A1 Schindler, Antonio
A1 Tison, François
A1 Vignatelli, Luca
A1 Meissner, Wassilios G.
YR 2019
UL http://n.neurology.org/content/93/14/630.abstract
AB Multiple system atrophy (MSA) is a neurodegenerative disorder characterized by a combination of autonomic failure, cerebellar ataxia, and parkinsonism. Laryngeal stridor is an additional feature for MSA diagnosis, showing a high diagnostic positive predictive value, and its early occurrence might contribute to shorten survival. A consensus definition of stridor in MSA is lacking, and disagreement persists about its diagnosis, prognosis, and treatment. An International Consensus Conference among experts with methodological support was convened in Bologna in 2017 to define stridor in MSA and to reach consensus statements for the diagnosis, prognosis, and treatment. Stridor was defined as a strained, high-pitched, harsh respiratory sound, mainly inspiratory, occurring only during sleep or during both sleep and wakefulness, and caused by laryngeal dysfunction leading to narrowing of the rima glottidis. According to the consensus, stridor may be recognized clinically by the physician if present at the time of examination, with the help of a witness, or by listening to an audio recording. Laryngoscopy is suggested to exclude mechanical lesions or functional vocal cord abnormalities related to different neurologic conditions. If the suspicion of stridor needs confirmation, drug-induced sleep endoscopy or video polysomnography may be useful. The impact of stridor on survival and quality of life remains uncertain. Continuous positive airway pressure and tracheostomy are both suggested as symptomatic treatment of stridor, but whether they improve survival is uncertain. Several research gaps emerged involving diagnosis, prognosis, and treatment. Unmet needs for research were identified.CPAP=continuous positive airway pressure; DISE=drug-induced sleep endoscopy; IRCCS-ISNB=Istituto di Ricovero e Cura a Carattere Scientifico delle Scienze Neurologiche di Bologna; MSA=multiple system atrophy; MSA-C=MSA-cerebellar; MSA-P=MSA-parkinsonian; VPSG=video polysomnography