Hindawi Publishing Corporation Case Reports in Otolaryngology Volume 2013, Article ID 763201, 4 pages http://dx.doi.org/10.1155/2013/763201 Case Report Recurrent Vocal Fold Paralysis and Parsonage-Turner Syndrome Marcus Vinicius Pinto, 1 Lucia Joffily, 2 and Maurice Borges Vincent 1 1 Department of Neurology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, 21941-590 Rio de Janeiro, Brazil 2 Department of Otorhinolaryngology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, 21941-590 Rio de Janeiro, Brazil Correspondence should be addressed to Marcus Vinicius Pinto; mvrpinto@gmail.com Received 9 August 2013; Accepted 25 September 2013 Academic Editors: Y. Baba and L.-F. Wang Copyright © 2013 Marcus Vinicius Pinto et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Parsonage-Turner syndrome, or neuralgic amyotrophy (NA), is an acute brachial plexus neuritis that typically presents with unilateral shoulder pain and amyotrophy but also can afect other peripheral nerves, including the recurrent laryngeal nerve. Idiopathic vocal fold paralysis (VFP) represents approximately 12% of the VFP cases and recurrence is extremely rare. Methods and Results. We report a man with isolated recurrent unilateral right VFP and a diagnosis of NA years before. Conclusions. We emphasize that shoulder pain and amyotrophy should be inquired in any patient sufering from inexplicable dysphonia, and Parsonage-Turner syndrome should be considered in the diferential diagnosis of idiopathic VFP. 1. Introduction Neuralgic amyotrophy (NA), or Parsonage-Turner syndrome, is an acute brachial plexus neuritis that typically presents with unilateral severe shoulder pain followed by patchy paresis and atrophy [1–3]. Although the pathophysiology of NA remains obscure, a predisposition for an acute immune attack towards the peripheral nerves following immunization, infections, exercise, labor, trauma, or surgery may occur [3, 4]. he incidence of 2-3 cases per 100,000 [5, 6] a year may not relect the real igures as NA is for a certainty underdiagnosed. Idiopathic neuralgic amyotrophy (INA) is ten times more common than hereditary neuralgic amyotrophy (HNA) [4]. he prognosis is generally good, as 90% of the patients are almost fully recovered ater 3 years [2]. he NA phenotype may vary to a large extent. Other segments of the peripheral nervous system (PNS) may be afected, such as the lumbosacral plexus, phrenic nerve, and the recurrent laryngeal nerve. he upper trunk of the brachial plexus is the most afected section, but involvement of single nerves, as the suprascapular, axillary, and anterior interosseus nerves, is common. he involvement of the recurrent laryngeal nerve is rare, particularly in INA [4, 7, 8]. here are only two reports of NA attacks presenting as vocal fold paralysis without pain or weakness [9, 10]. Unilateral vocal fold paralysis (VFP) is a disorder caused by dysfunction of the brainstem nuclei, the vague nerve, or the recurrent laryngeal nerve supplying the involved side of larynx. Nonlaryngeal malignancy and iatrogenic nerve injury are the major causes of unilateral VFP, while idiopathic cases correspond to approximately 12% of the patients [11]. Recent reports have shown a decrease in idiopathic cases, probably relecting better diagnostic capabilities [12]. he symptoms of unilateral VFP are related to immobility of the vocal fold causing glottic insuiciency. he primary symptom of unilat- eral VFP is dysphonia, expressed as hoarseness. With time, it can progress to aspiration of liquids and, in some cases, exertional dyspnoea [13]. Many cases of idiopathic unilateral VFP recover spontaneously leading to improvement in voice quality [11–13]. VFP recurrence is extremely unusual. here has been only one case of HNA with recurrent isolated VFP described in a child so far [9]. We report a patient with classical INA years before the development of recurrent unilateral VFP. To the best of our knowledge, this is the irst reported case of NA with isolated recurrent unilateral VFP.