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Correspondence |

Bilateral Vocal Cord Paralysis: A Rare Onset of Amyotrophic Lateral Sclerosis—Reply

Maaike Maria van der Graaff, MD; Marianne de Visser, MD, PhD
Arch Neurol. 2010;67(7):897-899. doi:10.1001/archneurol.2010.142.
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We thank Bigliardi and colleagues for their comments. The authors identified 1 case among 350 patients diagnosed with ALS in the province of Modena from 1990 to now that presented with stridor and hoarseness due to a bilateral vocal cord abductor paralysis at onset. Therefore, based on their own experience, they conclude that vocal cord dysfunction is quite rare at onset. Furthermore, Bigliardi et al refer to a publication by Puls et al1 in which a large family is described with lower motor neuron disease caused by a dynactin mutation. Affected members of this family developed early bilateral vocal cord paralysis. Bigliardi et al hypothesize that vocal cord dysfunction in ALS may be specifically related to a dynactin dysfunction.

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July 1, 2010
Maaike Maria van der Graaff, MD; Marianne de Visser, MD, PhD
Author Affiliations: Department of Neurology, Academic Medical Center, Amsterdam, the Netherlands.
Arch Neurol. 2010;67(7):897-899. doi:10.1001/archneurol.2010.142.
July 1, 2010
Teerin Liewluck, MD
Author Affiliation: Division of Neuropathology and Neurogenetics Network, Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Arch Neurol. 2010;67(7):896-897. doi:10.1001/archneurol.2010.124.
July 1, 2010
Guido Bigliardi, MD; Maria Chiara Malaguti, MD; Patrizia Sola, MD, PhD; Eleni Georgoulopoulou, MD; Manuela Tondelli, MD; Filippo Barbi, MD; Elena Canali, MD; Jessica Mandrioli, MD
Author Affiliations: Neurology Unit, Department of Neuroscience, University of Modena and Reggio Emilia, Nuovo Ospedale Civile S. Agostino Estense di Modena, Modena, Italy.
Arch Neurol. 2010;67(7):897-899. doi:10.1001/archneurol.2010.141.
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