Int Arch Otorhinolaryngol 2014; 18 - a2164
DOI: 10.1055/s-0034-1388853

Ziemssen Paralysis: A Case Report

Caroline Fernandes Rimoli 1, Carla Graciliano Arguello Nunes 1, Luis Alan Cardoso de Melo 1, Regina Helena Garcia Martins 1, Tatiana Maria Gonçalves 1, Thereza Lemos de Oliveira Queiroga 1
  • 1Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp)

Introduction: Bilateral vocal cord paralysis in most cases is a sign of underlying disease and the causes are many. Bilateral paralysis in abduction of the vocal folds, called Ziemssen paralysis is a rare presentation, usually secondary diseases of the central nervous system. Symptoms are weak and feeble voice and feeding difficulties by constant episodes of aspiration of food and saliva to the lower airways.

Objective: This study aims to report a rare case of Ziemssen paralysis.

Resumed Report: A 67-year-old male patient, emaciated, complained of poor, low, and weak dysphagia, voice, especially for liquids. He also noted dyspnea that began 1 day, while trying to drink water and lie down. He also reported a loss of 12 kg weight in 2 months. He was undergoing chemotherapy treatment for plasma cell leukemia. The videolaryngoscopy revealed bilateral vocal cord palsy in middle position with significant atrophy, hypertrophy, and ventricular bands bilateral salivary stasis in the vallecula and pyriform sinuses. The computed tomography of the skull base, neck, and chest revealed no changes. Ziemssen palsy was hypothesized and the patient was referred for neurological and gastroenterological detailed evaluation.

Conclusion: We present a rare case of bilateral vocal fold paralysis in abduction and discuss the difficulties in topodiagnosis.

Keywords: Ziemssen, paralysis.