Oropharyngeal dysphagia in multiple sclerosis

2010 ◽  
Vol 16 (3) ◽  
pp. 362-365 ◽  
Author(s):  
Marziyeh Poorjavad ◽  
Fatemeh Derakhshandeh ◽  
Masoud Etemadifar ◽  
Bahram Soleymani ◽  
Alireza Minagar ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Duration ◽  
Oropharyngeal Dysphagia ◽  
Neurological Impairment ◽  
Functional System ◽  
Swallowing Disorders ◽  
Limited Attention ◽  
Swallowing Function ◽  
Oral Stage ◽  
Dysphagic Patients

Swallowing disorders are commonly observed in multiple sclerosis (MS) patients. The complications of dysphagia are common causes of morbidity and death in late stages of MS. However, dysphagia in MS usually receives limited attention. The purpose of this study was to determine the prevalence of different kinds of swallowing disorders in MS patients with mild to moderate disability; and to identify possible associations between clinical and demographic features of patients and the presence of dysphagia. The swallowing functions of 101 consecutive MS patients were screened by the Northwestern Dysphagia Patient Check Sheet. This is a screening test which identifies patients with pharyngeal stage disorders, aspiration, oral stage disorders and/or pharyngeal delay. ‘Dysphagia’ was defined as having at least one of the above mentioned four disorders. Among 101 MS patients, 32 (31.7%) were classified as having dysphagia. Pharyngeal stage disorders were the most common observed impairment (28.7%) and aspiration, oral stage disorders, and pharyngeal delay were observed in 6.9%, 5%, and 1% of patients, respectively. Dysphagic patients had a significantly longer disease duration ( p = 0.031) and more neurological impairment in cerebellar functional system ( p = 0.04) when compared with non-dysphagic patients. Moreover, dysphagia was significantly more prevalent in patients with more neurological disability as measured by Expanded Disability Status Scale (EDSS) scores ( p = 0.04). These results emphasize the importance of assessment and management of swallowing function in MS patients, particularly in patients with a high EDSS score; more sever cerebellar dysfunction, and long disease duration.

scholarly journals Pre- and Post-Surgical Dysphagia in Adults with Tumors of the Posterior Fossa: A Prospective Blinded Study

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2561
Author(s):  
Sriramya Lapa ◽  
Johanna Quick-Weller ◽  
Christiane Nasari ◽  
Rainer Dziewas ◽  
Florian Gessler ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Tube Feeding ◽  
Oral Intake ◽  
Swallowing Disorders ◽  
Full Recovery ◽  
Surgical Removal ◽  
Imaging Data ◽  
Clinical Predictors ◽  
Swallowing Function ◽  
Dysphagic Patients

Background: While swallowing disorders are frequent sequela following posterior fossa tumor (PFT) surgery in children, data on dysphagia frequency, severity, and outcome in adults are lacking. The aim of this study was to investigate dysphagia before and after surgical removal of PFT. Additionally, we tried to identify clinical predictors for postsurgical swallowing disorders. Furthermore, this study explored the three-month outcome of dysphagic patients. Methods: In a cohort of patients undergoing PFT surgery, dysphagia was prospectively assessed pre- and postoperatively using fiberoptic endoscopic evaluation of swallowing. Patients with severe dysphagia at discharge were re-evaluated after three months. Additionally, clinical and imaging data were collected to identify predictors for post-surgical dysphagia. Results: We included 26 patients of whom 15 had pre-operative swallowing disorders. After surgery, worsening of pre-existing dysphagia could be noticed in 7 patients whereas improvement was observed in 2 and full recovery in 3 subjects. New-onset dysphagia after surgery occurred in a minority of 3 cases. Postoperatively, 47% of dysphagic patients required nasogastric tube feeding. Re-evaluation after three months of follow-up revealed that all dysphagic patients had returned to full oral intake. Conclusion: Dysphagia is a frequent finding in patients with PFT already before surgery. Surgical intervention can infer a deterioration of impaired swallowing function placing affected patients at temporary risk for aspiration. In contrast, surgery can also accomplish beneficial results resulting in both improvement and full recovery. Overall, our findings show the need of early dysphagia assessment to define the safest feeding route for the patient.

scholarly journals Examining the effects of ankyloglossia on swallowing function

2018 ◽  
Vol 44 (1) ◽  
pp. 5-21
Author(s):  
Kliss Moulton ◽  
◽  
John Seikel ◽  
Joni Loftin ◽  
Nancy Devine ◽  
...  
Keyword(s):  
Transit Time ◽  
Normative Data ◽  
Oropharyngeal Dysphagia ◽  
Swallowing Function ◽  
Transit Times ◽  
Oral Pressure ◽  
Oral Stage ◽  
Iowa Oral Pressure Instrument ◽  
Tongue Mobility

Oropharyngeal dysphagia (OPD) involves difficulty during one or more of the stages of swallowing, resulting in difficulty moving the bolus from the mouth to the stomach. A deficit in tongue mobility, such as that found with ankyloglossia, may affect the oropharyngeal transit time of the bolus and predispose a person to OPD. This study was conducted to examine the possible relationship between tongue tie and oropharyngeal dysphagia. Data were gathered on 8 participants (5 females, 3 males) between the ages of 12-43 years. The Lingual Frenulum Protocol (Marchesan, 2012) was used to determine tongue tie. An Iowa Oral Pressure Instrument (IOPI) measured tongue tip, tongue dorsum, and lip strength, and a combination of electromyography, and the five- finger palpation method measured laryngeal timing. Measurements were compared with normative data from Holzer (2011). Results revealed that participants with ankyloglossia had signs of oral stage dysphagia, including reduced articulator strength (tongue tip and dorsum, and lips) and reduced masseter activity. Oropharyngeal transit times were not significantly different from the norms.

scholarly journals DTI Measurements in Multiple Sclerosis: Evaluation of Brain Damage and Clinical Implications

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Emilia Sbardella ◽  
Francesca Tona ◽  
Nikolaos Petsas ◽  
Patrizia Pantano
Keyword(s):  
Multiple Sclerosis ◽  
Disease Duration ◽  
Diffusion Tensor ◽  
Effective Means ◽  
Neurological Impairment ◽  
Research Field ◽  
Microstructural Alterations ◽  
The Central Nervous System ◽  
Shed Light ◽  
Diffusion Tensor Imaging Dti

Diffusion tensor imaging (DTI) is an effective means of quantifying parameters of demyelination and axonal loss. The application of DTI in Multiple Sclerosis (MS) has yielded noteworthy results. DTI abnormalities, which are already detectable in patients with clinically isolated syndrome (CIS), become more pronounced as disease duration and neurological impairment increase. The assessment of the microstructural alterations of white and grey matter in MS may shed light on mechanisms responsible for irreversible disability accumulation. In this paper, we examine the DTI analysis methods, the results obtained in the various tissues of the central nervous system, and correlations with clinical features and other MRI parameters. The adoption of DTI metrics to assess the outcome of prognostic measures may represent an extremely important step forward in the MS research field.

Interhemispheric transfer evaluation in multiple sclerosis 1The authors would like to thank Claude-Alain Hauert and Christoph Michel for their assistance in the evaluation of motor tapping and Michel Habib for his suggestions and comments. This work was supported by a grant from the Swiss Society of Multiple Sclerosis.

2000 ◽  
Vol 59 (3) ◽  
pp. 150-158 ◽  
Author(s):  
Nadia Ortiz ◽  
Michael Reicherts ◽  
Alan J. Pegna ◽  
Encarni Garran ◽  
Michel Chofflon ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Corpus Callosum ◽  
Lexical Decision ◽  
Dichotic Listening ◽  
Neurological Impairment ◽  
Interhemispheric Transfer ◽  
Decision Task ◽  
Swiss Society ◽  
Listening Test ◽  
Relapsing Remitting

Patients suffering from Multiple Sclerosis (MS) have frequently been found to suffer from damage to callosal fibers. Investigations have shown that this damage is associated with signs of hemisphere disconnections. The aim of our study was to provide evidence for the first signs of interhemispheric dysfunction in a mildly disabled MS population. Therefore, we explored whether the Interhemispheric Transfer (IT) deficit is multi-modal and sought to differentiate two MS evolution forms, on the basis of an interhemispheric disconnection index. Twenty-two patients with relapsing-remitting form of MS (RRMS) and 14 chronic-progressive (CPMS) were compared with matched controls on four tasks: a tachistoscopic verbal and non-verbal decision task, a dichotic listening test, cross tactile finger localization and motor tapping. No overall impairment was seen. The dichotic listening and lexical decision tasks were the most sensitive to MS. In addition, CPMS patients' IT was more impaired and was related to the severity of neurological impairment. The different sizes of the callosal fibers, which determine their vulnerability, may explain the heterogeneity of transfer through the Corpus Callosum. Therefore, evaluation of IT may be of value as an index of evolution in MS.

scholarly journals Internet Usage by Patients with Multiple Sclerosis: Implications to Participatory Medicine and Personalized Healthcare

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Izabella Lejbkowicz ◽  
Tamar Paperna ◽  
Nili Stein ◽  
Sara Dishon ◽  
Ariel Miller
Keyword(s):  
Multiple Sclerosis ◽  
Support Groups ◽  
Disease Duration ◽  
Internet Usage ◽  
Online Health Information ◽  
Online Information ◽  
Improve Symptom ◽  
Disabled Patients ◽  
Healthcare Optimization ◽  
Participatory Medicine

Online health information and services for patients were suggested to improve symptom management and treatment adherence, thereby contributing to healthcare optimization. This paper aimed to characterize multiple sclerosis (MS) patients Internet usage. Information regarding browsing habits, Internet reliability, and the medical team's attitude to information collected online was obtained by questionnaires from MS patients. Data was compared between nonbrowsers, browsers on MS topics, and browsers on non-MS topics only. From the 96 patients recruited, 61 (63.5%) performed MS-related searches. The most viewed topics were “understanding the disease” and “treatments”. Patients reported that the information helped coping with MS and assured them of the appropriateness of their therapy. Shorter disease duration was correlated with higher Internet activity. Disabled patients were more interested in online interaction with specialists and support groups. This paper suggests that MS patients benefit from online information, and it emphasizes the importance of resources tailored to patients needs.

scholarly journals Swallowing disorders evaluation in multiple sclerosis

2013 ◽  
Vol 56 ◽  
pp. e353
Author(s):  
F. Fromont ◽  
A. Debavelaere ◽  
H. Cuvilier ◽  
A. Kwiatkowski ◽  
M.A. Guyot ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Swallowing Disorders

Clinical and laboratory features of neuromyelitis optica with oligoclonal IgG bands

2007 ◽  
Vol 13 (3) ◽  
pp. 332-335 ◽  
Author(s):  
M. Nakamura ◽  
I. Nakashima ◽  
S. Sato ◽  
I. Miyazawa ◽  
K. Fujihara ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Autoimmune Diseases ◽  
Myasthenia Gravis ◽  
Neuromyelitis Optica ◽  
Disease Duration ◽  
Sicca Syndrome ◽  
Common Features ◽  
Laboratory Features ◽  
Oligoclonal Igg ◽  
Oligoclonal Igg Bands

Of 23 neuromyelitis optica (NMO) cases, we found two cases with oligoclonal IgG bands (OBs). Both patients were positive for NMO-IgG. Their common features were long disease duration and co-existing autoimmune diseases (myasthenia gravis and sicca syndrome). Although OBs are mostly negative in NMO, which distinguishes it from multiple sclerosis (MS), they can be positive by long-standing autoimmunity, which may not be directly related to NMO. Multiple Sclerosis 2007; 13: 332-335. http://msj.sagepub.com

scholarly journals Patients with neuromyelitis optica have a more severe disease than patients with relapsingremitting multiple sclerosis, including higher risk of dying of a demyelinating disease

2013 ◽  
Vol 71 (5) ◽  
pp. 275-279 ◽  
Author(s):  
Denis Bernardi Bichuetti ◽  
Enedina Maria Lobato de Oliveira ◽  
Nilton Amorin de Souza ◽  
Mar Tintoré ◽  
Alberto Alain Gabbai
Keyword(s):  
Multiple Sclerosis ◽  
Neuromyelitis Optica ◽  
Disease Duration ◽  
Demyelinating Disease ◽  
Age Of Onset ◽  
Severe Disease ◽  
Expanded Disability Status Scale ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Relapsing Remitting Multiple Sclerosis

Although neuromyelitis optica (NMO) is known to be a more severe disease than relapsing-remitting multiple sclerosis (RRMS), few studies comparing both conditions in a single center have been done.Methods:Comparison of our previously published cohort of 41 NMO patients with 177 RRMS patients followed in the same center, from 1994 to 2007.Results:Mean age of onset was 32.6 for NMO and 30.2 for RRMS (p=0.2062) with mean disease duration of 7.4 years for NMO and 10.3 years for RRMS. Patients with NMO had a higher annualized relapse rate (1.0 versus 0.8, p=0.0013) and progression index (0.9 versus 0.6, p≪0.0001), with more patients reaching expanded disability status scale (EDSS) 6.0 (39 versus 17%, p=0.0036). The odds ratio for reaching EDSS 6.0 and being deceased due to NMO in comparison to RRMS were, respectively, 3.14 and 12.15.Conclusion:Patients with NMO have a more severe disease than patients with RRMS, including higher risk of dying of a demyelinating disease.

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