Tapia syndrome, also known as matador's disease, is a rare syndrome that is characterised by unilateral paralysis of the tongue and vocal cords. Although the syndrome typically occurs after anaesthetic airway management or manipulation, it can very rarely be due to central causes ¹¹.  The syndrome often mimics a brainstem stroke ^9,10 but much more commonly occurs due to simultaneous peripheral palsies of the recurrent laryngeal branch of the vagus nerve and the hypoglossal nerve ^1,2,5.

Clinical presentation

The classic clinical presentation of Tapia syndrome is ^2,4-6​:

• dysarthria and dysphonia

• dysphagia

• tongue weakness

• ipsilateral tongue deviation

  • will be absent in bilateral cases

Pathology

The aetiology of Tapia syndrome is nearly always peripheral, with central causes being exceptionally rare ¹¹. The following mechanisms have been proposed in the pathogenesis of peripheral iatrogenic Tapia syndrome ^4,5,7:

• inaccurate usage of laryngoscope

• intensified neck extension during anaesthesia manipulation

• prolong tension over trachea due to overinflation of endotracheal cuff

• extensive compression from throat packs over the trachea

Treatment and prognosis

In iatrogenic cases, most patients make a full recovery within six months without any specific management ².

History and etymology

This syndrome is eponymously named after the Spanish physician Antonio Garcia Tapia who first described it in a bullfighter, or "matador", wounded by a bullhorn in the neck. The syndrome has therefore sometimes been referred to as matador's disease.