Response from the Authors
Dear Sir: We would like to express appreciation for the comments given as well as for sharing your research findings in relation to the case. We agree that a neurological problem must be properly ruled out most expecially when there is a delayed onset of neurological symptoms with progression...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Philippine Society of Otolaryngology-Head and Neck Surgery, Inc.
2014-11-01
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| Series: | Philippine Journal of Otolaryngology Head and Neck Surgery |
| Subjects: | |
| Online Access: | https://pjohns.pso-hns.org/index.php/pjohns/article/view/441 |
| _version_ | 1819042211365388288 |
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| author | Reylan B. David William L. Lim |
| author_facet | Reylan B. David William L. Lim |
| author_sort | Reylan B. David |
| collection | DOAJ |
| description | Dear Sir:
We would like to express appreciation for the comments given as well as for sharing your research findings in relation to the case.
We agree that a neurological problem must be properly ruled out most expecially when there is a delayed onset of neurological symptoms with progression over time.
Indeed, the presence of vocal fold dysfunction in children should make one consider CNS pathologies most common of which is the Arnold- Chiari Malformation.
However, the following are our reasons for concurring with the pediatric neurology service in not requesting imaging:
• Aside from vocal fold paralysis, no other neurological symptom or finding was noted such as presence of swallowing and feeding difficulties, dizziness or uncoordination usually present in brainstem pathologies manifesting with vocal fold paralysis such as Chiari Type I1,2
• Previous and subsequent neurological examinations showed a bilaterally intact gag reflex which somewhat made the possibility of a CNS lesion affecting the vagus unlikely. No findings indicative of cerebellar dysfunction (such as dysdiadokinesia) were noted
Thank you very much.
Reylan B. David, MD
reylandavid@gmail.com
William L. Lim, MD |
| first_indexed | 2024-12-21T09:37:17Z |
| format | Article |
| id | doaj.art-df722c4a05374a48b04477c43243567f |
| institution | Directory Open Access Journal |
| issn | 1908-4889 2094-1501 |
| language | English |
| last_indexed | 2024-12-21T09:37:17Z |
| publishDate | 2014-11-01 |
| publisher | Philippine Society of Otolaryngology-Head and Neck Surgery, Inc. |
| record_format | Article |
| series | Philippine Journal of Otolaryngology Head and Neck Surgery |
| spelling | doaj.art-df722c4a05374a48b04477c43243567f2022-12-21T19:08:36ZengPhilippine Society of Otolaryngology-Head and Neck Surgery, Inc.Philippine Journal of Otolaryngology Head and Neck Surgery1908-48892094-15012014-11-0129210.32412/pjohns.v29i2.441Response from the AuthorsReylan B. David0William L. Lim1Department of Otorhinolaryngology Head and Neck Surgery Saint Luke’s Medical Center Quezon City, PhilippinesDepartment of Otorhinolaryngology Head and Neck Surgery Saint Luke’s Medical Center Quezon City, PhilippinesDear Sir: We would like to express appreciation for the comments given as well as for sharing your research findings in relation to the case. We agree that a neurological problem must be properly ruled out most expecially when there is a delayed onset of neurological symptoms with progression over time. Indeed, the presence of vocal fold dysfunction in children should make one consider CNS pathologies most common of which is the Arnold- Chiari Malformation. However, the following are our reasons for concurring with the pediatric neurology service in not requesting imaging: • Aside from vocal fold paralysis, no other neurological symptom or finding was noted such as presence of swallowing and feeding difficulties, dizziness or uncoordination usually present in brainstem pathologies manifesting with vocal fold paralysis such as Chiari Type I1,2 • Previous and subsequent neurological examinations showed a bilaterally intact gag reflex which somewhat made the possibility of a CNS lesion affecting the vagus unlikely. No findings indicative of cerebellar dysfunction (such as dysdiadokinesia) were noted Thank you very much. Reylan B. David, MD reylandavid@gmail.com William L. Lim, MDhttps://pjohns.pso-hns.org/index.php/pjohns/article/view/441neurology |
| spellingShingle | Reylan B. David William L. Lim Response from the Authors Philippine Journal of Otolaryngology Head and Neck Surgery neurology |
| title | Response from the Authors |
| title_full | Response from the Authors |
| title_fullStr | Response from the Authors |
| title_full_unstemmed | Response from the Authors |
| title_short | Response from the Authors |
| title_sort | response from the authors |
| topic | neurology |
| url | https://pjohns.pso-hns.org/index.php/pjohns/article/view/441 |
| work_keys_str_mv | AT reylanbdavid responsefromtheauthors AT williamllim responsefromtheauthors |