Shy-Drager Syndrome with Bilateral Vocal Cord Paralysis; A Report of Two Cases.

Shy-Drager syndrome is a rare disease characterized by autonomic failure and multiple system atrophy. Vocal cord paralysis is sometimes a feature of this syndrome. We report two cases of Shy-Drager syndrome with bilateral vocal cord paralysis.Case 1 is a 69-year-old woman. She first visited our hospital because of stridor without dyspnea. Indirect laryngoscopy revealed bilateral vocal cord paralysis, but radiographic examinations showed no specific cause. We recommended tracheotomy, but she refused it. Six months later she received an emergency tracheotomy because of sudden dyspnea.Case 2 is a 66-year-old man. He first visited our hospital because of stridor with dyspnea. Indirect laryngoscopy revealed bilateral vocal cord paralysis. He received an emergency tracheotomy. These two patients had similar clinical features, such as postural hypotension and other systemic neurological disorders, which led to the diagnosis of Shy-Drager syndrome.