Hereditary neuropathy and vocal cord paralysis in a man with childhood diphtheria.

We present the case of a 37-year-old Afghani man with a history of childhood diphtheria, who was diagnosed with bilateral vocal cord paralysis at age 15 years. At about this time he developed progressive muscular wasting and distally predominant weakness, and subsequently developed respiratory insufficiency, necessitating nocturnal ventilatory support. His examination suggested a distal symmetric sensorimotor neuropathy, and his brother was similarly affected, although to a lesser degree. Electromyography (EMG) and nerve conduction studies revealed this process to be purely axonal. A diagnosis of possible hereditary motor and sensory neuropathy (HMSN) type IIc, hereditary axonal polyneuropathy with vocal cord paralysis, is proposed, although the question of early diphtheritic involvement of the vocal cords and peripheral nerves is also considered.

Extraocular muscle involvement in Becker muscular dystrophy.

We report limitation of gaze and slow saccadic eye movements by clinical examination and video-oculography in a patient with Becker muscular dystrophy. This rare association suggests that a dystrophinopathy should be considered in a patient with features characteristic of Becker muscular dystrophy even when mild impairment of eye movements is present.

Chart review of alcohol problems in adolescent psychiatric patients in an emergency room.

Of 459 consecutive teenage patients seen for psychiatric evaluations in a general hospital emergency room during a 1-year period, 76 (17%) had blood alcohol levels over 100 mg/dl. Males and females were represented equally in this group. The most common DSM-III diagnoses in these patients were affective disorders and conduct disorders.