OBJECTIVES/HYPOTHESIS To assess the possible predictive factors for permanent laryngoplasty (PL) in patients with acute unilateral vocal fold paralysis (UVFP), and to assess the effects of early vocal cord hyaluronic acid injection. STUDY DESIGN Prospective cohort study. METHODS Patients diagnosed with UVFP within the previous 6 months were enrolled. Initial and follow-up videolaryngostrobo...

Hypokalemic Periodic Paralysis is one form of Periodic Paralysis, a rare group of disorders that can cause of sudden onset weakness. A case of a 29 year old male is presented here. The patient presented with sudden onset paralysis of his extremities. Laboratory evaluation revealed a markedly low potassium level. The patient's paralysis resolved upon repletion of his low potassium and he was dis...

In skeletal muscle, slow inactivation (SI) of Na(V)1.4 voltage-gated sodium channels prevents spontaneous depolarization and fatigue. Inherited mutations in Na(V)1.4 that impair SI disrupt activity-induced regulation of channel availability and predispose patients to hyperkalemic periodic paralysis. In our companion paper in this issue (Silva and Goldstein. 2013. J. Gen. Physiol. http://dx.doi....

Muscle fibers from individuals with hyperkalemic periodic paralysis generate repetitive trains of action potentials (myotonia) or large depolarizations and block of spike production (paralysis) when the extracellular K+ is elevated. These pathologic features are thought to arise from mutations of the sodium channel alpha subunit which cause a partial loss of inactivation (steady-state Popen app...

Paramyotonia congenita, the major characteristics of which are cold-induced and exercise-induced myotonia, is an autosomal-dominant muscle disease which is classified into one of a group of muscle diseases, so-called muscle "sodium channelopathies" caused by missense mutations in the gene coding for the skeletal muscle sodium channel a-subunit (SCN4A) (1-4). Such muscle sodium channelopathies s...

OBJECTIVE To analyze laryngeal aerodynamics in the same patient in 4 different circumstances: before the onset of unilateral vocal fold paralysis (UVFP), after the onset of UVFP, and after 2 types of surgical vocal fold medialization techniques to compare the results of surgery with the measurements made in that same patient when his larynx was healthy (before paralysis). DESIGN Prospective s...

The authors investigated indication for phonosurgery for treatment of unilateral vocal fold paralysis based on laryngeal tomographs taken during sustained phonation of the vowel/u/, using a computed radiography system. As pre-operative quantitative indices, the thickness ratio (the ratio of the frontal sectional area of the paralyzed vocal fold to that of the other side, TR) and the level diffe...

EEG recording in the intensive care setting presents a number of technical challenges. It is essential to differentiate artifact from pathophysiologic EEG changes that would suggest encephalopathy, epileptiform activity, or seizures. There are particular patterns typical of deepening encephalopathy, as well as, coma patterns that have diagnostic and prognostic significance (e.g., spindle coma, ...

In 1865, Claude Bernard wrote that ‘the constancy of the internal milieu is the essential condition to a free and independent life’ [1]. It would be hard to find a more illustrative paradigm for that statement than for the case of hyperkalaemic periodic paralysis (HyperPP) reported by Grgic et al. in this issue [2]. A 14-year-old male was admitted for a sudden ascending paralysis involving the ...