[A deglutition stutterer. Contribution on psychogenic inability to swallow]

Area of Science:

• Neurology
• Gastroenterology
• Psychiatry

Background:

• Progressive onset of neurological and muscular dysfunction impacting essential physiological processes.
• Understanding the long-term effects of stress on autonomic nervous system regulation.

Observation:

• A 63-year-old patient presented with tongue fasciculations and hypopharyngeal muscle contraction during swallowing, starting at age 50.
• Symptoms led to inanition (malnutrition) and exsiccosis (dehydration), necessitating intravenous fluid dependence.
• Psychological evaluation revealed a history of pharyngeal spasms in youth, recurring under stress in later life.

Findings:

• The patient self-administered nasal intubation for liquid intake.
• Combined physiotherapy and psychotherapy resulted in personality harmonization.
• Autonomic swallowing dysfunction remained incompletely resolved despite therapeutic interventions.

Implications:

• Highlights the complex interplay between neurological, muscular, and psychological factors in swallowing disorders.
• Suggests potential long-term autonomic dysregulation triggered by stress, manifesting as oropharyngeal dysfunction.
• Emphasizes the need for integrated treatment approaches for chronic, multifactorial conditions affecting deglutition.