A case of acute oropharyngeal palsy with palatoplegia as the initial symptom

DOI
  • Jimura Tomohiro
    Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences
  • Kawabata Masaki
    Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences
  • Nagano Hiromi
    Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences
  • Kurono Yuichi
    Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences

Bibliographic Information

Other Title
  • 軟口蓋麻痺で発症した acute oropharyngeal palsy 例

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Description

<p>　 We describe herein a case of acute oropharyngeal palsy (AOP), a rare subtype of Guillain-Barre syndrome (GBS). After the initial report of 3 AOP cases by O'Leary et al. in 1996, several other cases have been reported, but no disease concept, diagnostic criteria, or treatment have been established. Furthermore, there has been no report of AOP in the otolaryngology literature. A 16-year-old male presented with initial symptom of palatoplegia characterized by poor lifting of the bilateral soft palates, rhinolalia aperta, and slight loss of pharyngeal reflex. Acute development of peripheral nerve disease and a GBS subtype were suspected. Diagnosis of AOP is based on the presence of anti-ganglioside antibodies and elevation of anti-GQ1b-IgG and anti-GT1a-IgG antibody levels. The anti-GQ1b-IgG antibody level was (2+), the anti-Ga1NAc-GD1a-IgM antibody level was (2+), the anti-GT1a-IgM antibody level was (1+), and the IgG antibody level was (2+). Other antibodies were negative. Based on the clinical symptoms, course, and antibody test results, the patient was diagnosed as having AOP. The symptoms gradually improved over the time course with observation alone and disappeared after about one month. The findings of this case suggests that subtypes of GBS should be considered in an oropharyngeal examination. Otolaryngologists who routinely perform oropharyngeal examinations should take the subtype diseases of GBS into consideration as a potential cause of acute development of rhinolalia aperta and nasopharyngeal reflux.</p>

Journal

  • Stomato-pharyngology

    Stomato-pharyngology 30 (2), 171-174, 2017

    Japan Society of Stomato-pharyngology

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