A case of spinal and bulbar muscular atrophy with acute bilateral vocal cord paralysis suddenly apparent after infection

A 50-year-old Japanese man, who experienced cold symptoms for 11 days, presented to our hospital complaining of hoarseness and dyspnea from the morning of the day of the visit. Laryngoscopy revealed bilateral vocal cord paralysis, and tracheotomy was performed. Specific post-admission interviews revealed that he had suffered from postural finger tremor from 30 years of age, fasciculations of his facial muscle from 47 years of age, and mild dysphagia from 49 years of age. Blood tests showed high serum CK levels, chest computed tomography (CT) revealed gynecomastia, and needle electromyography showed neurogenic changes. An abnormal expansion of the CAG repeat in the androgen receptor gene (47) was found, and spinal and bulbar muscular atrophy (SBMA) was diagnosed. Although SBMA is a rare cause of vocal cord paralysis, this disease should be considered as a differential diagnosis in patients with history or physical findings that are characteristic of SBMA.