Patients with either vocal fold paresis or paralysis may exhibit a breathy voice quality. Recurrent laryngeal nerve damage is the most common cause of vocal fold paresis. Some patients experience paralysis or paresis, temporarily or permanently. The parenchymal syphilis, presents as tabes dorsalis and general paresis. These present as ataxia, paresis, loss of vision, behavioural changes and seizures. As the disease progresses, the paresis and paralysis gradually move forward. Additionally, superior laryngeal nerve damage (SLN) can also lead to vocal fold paresis. Other signs may include hyperopia due to accommodative paresis, photophobia and difficulty reading. A further surgical intervention used to mitigate vocal fold paresis is laryngeal reinnervation. Glottal insufficiency is another common symptom observed in vocal fold paresis. Symptoms are frequently accompanied by visual disturbances such as gaze paresis, reduced vision, and dizziness. An infant with Todd's paresis does not necessarily preclude the diagnosis of a febrile convulsion. A consequence of reflex interruption is that muscle tone is reduced, resulting in flaccid paresis. This may be accompanied by difficulty swallowing and vocal cord paresis. Hideyo Noguchi's discovery of "Treponema pallidum" in the brain in patients with general paresis.