Laryngeal electromyography findings in a patient with HIV, John Cunningham virus and bilateral true vocal fold motion impairment.

We present the findings from laryngeal electromyography (EMG) on a 33-year-old HIV-positive male who presented with decreased vocal endurance and a breathy voice. Management considerations were broadened by the history of John Cunningham (JC) virus recovered from his cerebrospinal fluid and the consequent diagnosis of progressive multifocal leukoencephalopathy. We reviewed the available literature on neuropathy, HIV, JC virus and how all these factors relate to voice disturbances. We present laryngeal EMG findings, discuss the benefit of electrodiagnostic studies, and offer an algorithm for interpreting this information and applying it to create the optimal care plan for these patients. As medical management of HIV-related diseases continues to improve, more patients may present with similar circumstances.