Swallowing abnormalities in multiple sclerosis: correlation between videofluoroscopy and subjective symptoms

Area of Science:

• Neurology
• Gastroenterology
• Speech-Language Pathology

Background:

• Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
• Dysphagia, or impaired swallowing, is a potential complication of neurological disorders.
• Clinical assessment of swallowing in MS patients may underestimate the prevalence of dysphagia.

Purpose of the Study:

• To investigate the correlation between subjective swallowing symptoms and objective videofluoroscopic findings in patients with multiple sclerosis (MS).
• To determine the prevalence of subclinical swallowing abnormalities in MS patients.

Main Methods:

• Videofluoroscopic swallowing examinations (VFSE) were performed on 18 patients diagnosed with MS.
• Examinations were independently analyzed by a radiologist and a speech-language pathologist (logopedist).
• Videofluoroscopic findings were compared with patient-reported swallowing symptoms.

Main Results:

• All 4 patients with permanent dysphagia exhibited aspiration during VFSE.
• All 6 patients reporting intermittent swallowing difficulties showed epiglottic undercoating and/or laryngeal penetration.
• Among 8 asymptomatic patients, only 2 had normal videofluoroscopic swallowing function, indicating frequent subclinical dysphagia.

Conclusions:

• Swallowing abnormalities are more prevalent in MS patients than typically recognized through clinical evaluation alone.
• Videofluoroscopy is crucial for detecting dysphagia in MS, as many patients exhibit impairments without subjective symptoms.
• Early detection and management of swallowing dysfunction are essential for improving quality of life in MS patients.