Table 1

Patients with multiple system atrophy who initially presented with laryngeal abductor paralysis/stridor

Patient*	Years from the onset of illness														Laryngoscopy findings†
Patient*	0	1	2	3	4	5	6	7	8	9	10	11	12	13	Laryngoscopy findings†
*Age, sex, diagnosis.
†Laryngeal abductor paralysis: +(mild), ++(moderate), +++(severe), Isozaki’s classification.
AHI, apnoea hypopnoea index; BD, bladder dysfunction; CPAP, continuous positive airway pressure; F, female; HUT, head up tilt (60° for 10 min); M, male; MSA-C, cerebellar form of multiple system atrophy; MSA-P, parkinsonian form of multiple system atrophy; ODI, oxygen desaturation index (dips per hour); PH, postural hypotension; RBD, REM sleep behavioural disorder; SAS, sleep apnoea syndrome.
1. 62/M MSA-P	Laryngeal stridor						BD	Decreased sweating	Akinesia, cerebellar ataxia, PH		Admission: tracheotomy				++
2. 74/F MSA-P	Laryngeal stridor					Constipation, BD, PH, akinesia	Admission: inspiratory gasp, hoarseness								+++
3. 83/F MSA-C	Laryngeal stridor, inspiratory gasp					Ataxic gait, BD, constipation			PH	Admission: tracheotomy	Akinesia			Pneumonia, Admission:gastrostomy	+++
4. 59/F MSA-C	Laryngeal stridor, RBD		Ataxic gait			BD	Admission: CPAP >tracheotomy								++
5. 62/M MSA-C	Laryngeal stridor	Constipation, BD		Admission: ataxic gait, akinesia, inspiratory gasp; CPAP		Admission: tracheotomy									+++
6. 57/F MSA-P	Laryngeal stridor, hoarseness	Hand tremor	Dysphasia	akinesia, ataxic gait, BD	Admission: laser incision >tracheotomy										+++
7. 53/M MSA-P	Laryngeal stridor, hoarseness, BD, erectile dysfunction, constipation	PH, decreased sweating, ataxic gait			Admission: dysphagia										++
8. 63/F MSA-C	Laryngeal stridor, ataxic gait	Admission hoarseness, akinesia; CPAP													+++