Vocal Cord Paralysis in Multifocal Motor Neuropathy: A Case Report

Multifocal motor neuropathy is characterized by a slow, progressive, asymmetrical weakness of the extremities without sensory loss. The disease can also cause vocal cord paralysis as it runs its course. A 34-year-old man developed progressive weakness in his hand muscles for one year. Dysphonia was also present for a three week period. Neurological examination revealed there was moderate weakness and mild muscle wasting in the distal muscles of the upper limbs, predominantly in the left hand. Left laryngeal nerve palsy was also discovered during his otolaryngological examination. Nerve conduction studies revealed multiple sites of conduction block without sensory abnormalities consisting of selective involvement of motor fibers. The patient received intravenous immunoglobulin treatment after a diagnosis of multifocal motor neuropathy. Multifocal motor neuropathy with conduction block is rarely associated with vocal cord paralysis. This condition should be kept in mind in cases of laryngeal nerve palsy with an asymmetric motor neuropathy, as patients might benefit from intravenous immunoglobulin treatment. (Turkish Journal of Neurology 2012; 18:114-7)