Objectives: To characterize swallowing deficits in amyotrophic lateral sclerosis (ALS); investigate the delay in dysphagia onset; estimate correlations between dysphagia severity and patients' functional status; identify the symptom(s) most likely to predict dysphagia. Materials and methods: A group of 49 consecutive patients with ALS, 14 with bulbar onset and 35 with spinal onset, underwent swallowing evaluation including bedside and fiberoptic endoscopic examination to detect dysphagia. Results: Patients with dysphagia were more likely than those without to have bulbar onset ALS (P = 0.02); more severely impaired chewing (P = 0.01); and tongue muscle deficits (P = 0.001). The only variable measured at first examination significantly associated with dysphagia was a more than mild tongue muscle deficit. The only variable useful in predicting dysphagia was a chewing deficit. In 10 of the 49 patients studied, swallowing evaluation disclosed an impaired cough reflex. Conclusions: Dysphagia in patients with ALS correlates significantly with bulbar onset and with oral swallowing impairment. Fiberoptic swallowing evaluation is a useful tool for detecting swallowing deficits and laryngeal sensitivity in patients with ALS. An impaired cough reflex is an unexpected finding in many patients with ALS. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Dysphagia in amyotrophic lateral sclerosis: prevalence and clinical findings / Ruoppolo, Giovanni; Schettino, Ilenia; Frasca, Vittorio; Giacomelli, Elena; Prosperini, Luca; Cambieri, Chiara; Roma, Rocco; Greco, Antonio; Mancini, Patrizia; DE VINCENTIIS, Marco; V., Silani; Inghilleri, Maurizio. - In: ACTA NEUROLOGICA SCANDINAVICA. - ISSN 0001-6314. - 128:6(2013), pp. 397-401. [10.1111/ane.12136]
Dysphagia in amyotrophic lateral sclerosis: prevalence and clinical findings.
RUOPPOLO, Giovanni;SCHETTINO, ILENIA;FRASCA, VITTORIO;GIACOMELLI, ELENA;PROSPERINI, luca;CAMBIERI, CHIARA;ROMA, Rocco;GRECO, Antonio;MANCINI, PATRIZIA;DE VINCENTIIS, Marco;INGHILLERI, Maurizio
2013
Abstract
Objectives: To characterize swallowing deficits in amyotrophic lateral sclerosis (ALS); investigate the delay in dysphagia onset; estimate correlations between dysphagia severity and patients' functional status; identify the symptom(s) most likely to predict dysphagia. Materials and methods: A group of 49 consecutive patients with ALS, 14 with bulbar onset and 35 with spinal onset, underwent swallowing evaluation including bedside and fiberoptic endoscopic examination to detect dysphagia. Results: Patients with dysphagia were more likely than those without to have bulbar onset ALS (P = 0.02); more severely impaired chewing (P = 0.01); and tongue muscle deficits (P = 0.001). The only variable measured at first examination significantly associated with dysphagia was a more than mild tongue muscle deficit. The only variable useful in predicting dysphagia was a chewing deficit. In 10 of the 49 patients studied, swallowing evaluation disclosed an impaired cough reflex. Conclusions: Dysphagia in patients with ALS correlates significantly with bulbar onset and with oral swallowing impairment. Fiberoptic swallowing evaluation is a useful tool for detecting swallowing deficits and laryngeal sensitivity in patients with ALS. An impaired cough reflex is an unexpected finding in many patients with ALS. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.