Bilateral vocal cord paralysis during emergence from general anesthesia in a patient with Parkinson's disease

Parkinson's disease (PD) is a neurodegenerative disorder that affects the extrapyramidal system, and respiratory dysfunction has also been noted in patients with PD. However, acute upper airway obstruction due to bilateral vocal cord paralysis is a very rare finding in PD. Here, we describe a rare life-threatening respiratory failure caused by bilateral vocal cord paralysis in an elderly woman with PD during emergence from general anesthesia. The tracheostomy was performed on the postoperative period because the condition persisted. The general anesthesia in PD may have aggravated vocal cord impairment. We recommend when a patient with PD is scheduled for general anesthesia that the anesthesiologist performs careful preoperative examinations, strictly monitors respiratory function, and rapidly manages acute upper airway obstruction.