We report a 60-year-old woman with juvenile Parkinson disease (PD) with vocal 
cord abductor paralysis (VCAP). She had suffered from juvenile PD for 30 years. 
She was admitted in February 1998 to our clinical unit, because of malignant 
syndrome induced by dehydration. Neurological examination revealed disturbance 
of consciousness, hand tremor, dyskinesia of the trunk and all extremities, and 
rigidity. Laboratory examinations disclosed leukocytosis, renal dysfunction, 
hypermyoglobinemia, and elevation of the serum creatine kinase. Six days after 
admission, dyspnea and inspiratory stridor were noted, and the respiratory 
distress worsened. Endoscopy of the upper airways revealed that the vocal cord 
was in the midline or paramedian position. There are some cases of PD with VCAP, 
but such a case is very rare in Japan. We discussed the pathogenic mechanisms of 
these conditions, and speculated that VCAP was associated with malignant 
syndrome in our case.