Related Experiment Videos
Swallowing in motor neurone disease
S E Leighton1, M J Burton, W S Lund
1Department of Otolaryngology, Radcliffe Infirmary, Oxford, UK.
Journal of the Royal Society of Medicine
|December 1, 1994
Summary
Motor neurone disease often causes severe swallowing problems, particularly in bulbar palsy. Videofluoroscopy aids assessment, but clinical evaluation is crucial for surgical decisions like cricopharyngeal myotomy.
Area of Science:
- Neurology
- Gastroenterology
Background:
- Motor neurone disease (MND) significantly impacts swallowing function.
- Bulbar palsy, progressive muscular atrophy, and amyotrophic lateral sclerosis are common presentations of MND affecting swallowing.
Purpose of the Study:
- To assess swallowing difficulties in motor neurone disease patients.
- To correlate clinical and radiological findings with swallowing problems.
- To evaluate the efficacy and safety of surgical interventions for dysphagia in MND.
Main Methods:
- Clinical and radiological (videofluoroscopy) assessments of 92 MND patients.
- Analysis of swallowing difficulty prevalence based on MND subtype.
- Review of outcomes for patients undergoing cricopharyngeal myotomy and pharyngostomy.
Main Results:
- 89% of bulbar palsy patients had severe swallowing issues; 45% of PMA and 29% of ALS patients also experienced difficulties.
- Videofluoroscopy showed abnormalities in patients with severe dysphagia, but radiological findings did not always correlate with symptoms.
- Cricopharyngeal myotomy had an 89% satisfaction rate despite complications; pharyngostomy had a high complication rate.
Conclusions:
- Swallowing problems are prevalent in MND, varying by subtype.
- Radiological findings should complement clinical assessment for surgical candidacy.
- Cricopharyngeal myotomy is recommended for selected pseudobulbar patients; pharyngostomy carries significant risks.