Effects of Effortful Swallowing Exercise with Progressive Anterior Tongue Press Using Iowa Oral Performance Instrument (IOPI) on the Strength of Swallowing-Related Muscles in the Elderly: A Preliminary Study

alwin shared this article with you from Inoreader Effects of Effortful Swallowing Exercise with Progressive Anterior Tongue Press Using Iowa Oral Performance Instrument (IOPI) on the Strength of Swallowing-Related Muscles in the Elderly: A Preliminary Study Via Dysphagia In this study, 20 healthy elderly people (76.65  ± 5.87 years; 10 women and 10 men) participated and exercised for 7 weeks. The experimental group performed ES exercise combined with external resistance using Iowa Oral Performance Instrument (IOPI), and the control group performed pure ES without external resistance. The exercises were per formed for 20 min a day, 2 days a week for 7 weeks in both groups. ES was repeated 60 times in weeks 1 and 2, 80 times in week 3 and 4, and 120 times in weeks 5–7. In the experimental group, the isometric and swallowing tongue pressures at week 8 were significantly improved compared to baseline . At week 8, the anterior and swallowing tongue pressures and anterior tongue endurance were significantly higher than those of the control group. In ... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

New Radioprotective Device that can be Used for Fluoroscopic Exam: Possibility to Contribute to Staff Exposure Protection During VFSS

alwin shared this article with you from Inoreader New Radioprotective Device that can be Used for Fluoroscopic Exam: Possibility to Contribute to Staff Exposure Protection During VFSS Via Dysphagia AbstractThe videofluoroscopic swallowing study (VFSS) is a recognized standard diagnostic imaging technique that is used to investigate swallowing disorders and dysphagia. Patients were assessed in a seated posture on a chair or wheelchair. Using X-ray fluoroscopy, the state of patients ' swallowing was checked by eating and drinking according to the physician's instructions. VFSS procedures are prolonged, and VFSS staff members are exposed to radiation. Therefore, we evaluated original lead shielding device (OLSD) that can be attached to the handrail of a table and placed vertic ally. The OLSD has a lead-equivalent thickness of 0.3 mmPb, weighs about 6 kg, and has the dimensions 50 cm × 50 cm × 8.0 mm. We used a human phantom and a radiation survey meter with and without p... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevalence and Risk Factors of Dysphagia in Patients with Multiple Sclerosis

alwin shared this article with you from Inoreader Prevalence and Risk Factors of Dysphagia in Patients with Multiple Sclerosis Via Dysphagia AbstractDysphagia is one of the most common symptoms in multiple sclerosis (MS) patients. It can reduce the quality of life and increase the risk of mortality by developing complications such as aspiration pneumonia. The present study was conducted to estimate the prevalence of dysphagia in MS patients and investigate the associations between dysphagia and disease characteristics. The Persian version of the DYMUS questionnaire was used to assess dysphagia in 865 patients with MS, including 738 (85.3%) relapsing –remitting MS (RRMS), 106 (12.3%) secondary progressive MS (SPMS), and 21 (2.4%) primary progressive MS (PPMS). Also, demographic and clinical data, including age, sex, smoking status, Expanded Disability Status Scale (EDSS) score, disease duration, disease-modifying therapies exp... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Rare Case of Dysphagia with Palatal Tremor

alwin shared this article with you from Inoreader Message: Case Presentation A 77-year-old man with a known history of long-standing hypertension experienced a left cerebellar hemorrhage 9 months ago, then a right cerebellar hemorrhage 3 months prior to his presentation. The patient had noticeable dysphagia that required placing a nasogastric tube for nasal feeding. The standardized swallowing assessment revealed that he had an impairment in lip closure, head, and trunk control, pharyngeal reflex, as well as independent coughing. To observe the pathophysiological changes of the pharynx and larynx, a fiberoptic laryngoscope was inserted prior to the video fluoroscopic swallowing study (VFSS), which showed that there was no pathophysiological change. VFSS detected the rhythmic tremor of the soft palate and epiglottis, with residues displayed in the vallecula and pyriform sinuses. Magnetic resonance imaging (MRI) depicted bilateral long T2 signal shadows in the cerebellum, enlargement of the bilateral olivary nucleus, with a longer T2-weighted signal change. The T2 FLAIR image demonstrated an increased signal change, with the right inferior olivary nucleus (ION) obviously larger than the left. (Fig. 1) (9 months after the left cerebellar hemorrhage, 3 months after the right cerebellar hemorrhage). Fig. 1 figure 1 Axial T2 and FLAIR images: long T2 signal shadows were observed in the right cerebellum, and low-density circular shadows were observed around the lesion, with patchy long T2 signal changes in the left cerebellum. The area of the bilateral olivary nucleus was enlarged, with a longer T2-weighted signal change, and the T2 FLAIR image showed an increased signal change, the right ION was obviously larger than the left Full size image Diagnosis The patient presented with a palatal tremor (PT) after two episodes of cerebellar hemorrhage. MRI indicated bilateral hypertrophic degeneration of the olivary nucleus, especially on the left side. These findings taken together confirmed a diagnosis of hypertrophic olivary degeneration (HOD). HOD is a rare neurological condition characterized by trans-synaptic degeneration that occurs secondary to focal lesions disrupting the normal function of the afferent fibers to the ION as part of the dentate–rubro–olivary pathways (Guillain–Mollaret triangle, GMT) [1]. Possible etiologies for this condition include infarction, toxicosis, trauma, surgery, tumors, vascular malformations or hemorrhage. In this case, the patient developed HOD secondary to cerebellar hemorrhage [2]. Discussion GMT is composed of the contralateral dentate nucleus (DN), the ipsilateral red nucleus (RN) and the ipsilateral ION. DN, RN, and ION form an afferent and efferent loop pathway. The fibers from the DN are crossed by the superior cerebellar foot and reach the contralateral midbrain red nucleus. The red nucleus sends fibers descending through the central tegmental bundle to the ipsilateral ION for relay. The ION is then emitted from fibers passing through the cerebellar inferior foot (ICP) to the contralateral cerebellar cortex and projected onto the DN, constituting the complete GMT [2] (Fig. 2). Fig. 2 figure 2 Guillain–Mollaret triangle Full size image When the primary lesion is located within the cerebellum, contralateral ION degeneration occurs, which is due to the decussation of the dentate-rubral fibers. A unilateral lesion in a cerebellar hemisphere usually causes contralateral HOD, and only a rare number of cases of bilateral HOD have been described with lesions affecting a single cerebellar hemisphere [2]. HOD is characterized by enlargement and increased T2 hyperintense signal of the ION [3]. The classic clinical presentation associated with HOD is a PT [4] which was observed in this patient. Dentatorubral tremors and ocular myoclonus are other associated movement disorders [4], but were not observed in this case. This muscle tremor may affect the patient's peristalsis, which is manifested as an incomplete epiglottic closure during swallowing, food residues in the vallecula and pyriform sinuses, leading to penetration-aspiration, resulting in dysphagia. The exact pathogenesis of the tremor is not clear, but the currently accepted hypothesis involves the interruption of GABAergic descending inhibition of the dentate–olivary tract during de-afferentiation of the triangle [5]. We treated the patient with electric stimulation, vocal cord movement and airway protection training for dysphagia, but the results were not satisfactory. Previous literature reports indicated that the medical treatment of PT is unsatisfactory and is often ineffective. some patients may respond to medications such as valproic acid, carbamazepine, clonazepam, tryptophan, trihexyphenidyl, or levetiracetam [6]. This patient was treated sequentially with propranolol, clonazepam, and levetiracetam, but his symptoms persisted. Conclusion In this study, we report an unusual case of dysphagia following two episodes of cerebellar hemorrhage. Despite the fact that dysphagia after stroke is fairly common, the different etiologies and pathogenesis related to this condition should be identified, especially the rare causes of dysphagia. The patient is not responding well to treatment; thus, we need to follow up him for a long period of time to observe the changes in his condition. References Onen MR, Moore K, Cikla U, et al. Hypertrophic olivary degeneration: neurosurgical perspective and literature review. World Neurosurg. 2018;112:763–71. Article Google Scholar Wang H, Wang Y, Wang R, et al. Hypertrophic olivary degeneration: a comprehensive review focusing on etiology. Brain Res. 2019;1718:53–63. CAS Article Google Scholar Goto N, Kaneko M. Olivary enlargement: chronological and morphometric analyses. Acta Neuropathol. 1981;54(4):275–82. CAS Article Google Scholar Cosentino C, Velez M, Nuñez Y, et al. Bilateral hypertrophic olivary degeneration and Holmes tremor without palatal tremor: an unusual association. Tremor Other Hyperkinet Mov (NY). 2016;6:400. Article Google Scholar Walker G, Limaye K, Jankowitz BT, et al. Hypertrophic olivary degeneration after cerebellar hemorrhage. J Clin Neurosci. 2017;43:162–4. Article Google Scholar Diehl GE, Wilmes E. Etiology and clinical aspects of palatal myoclonus. Laryngorhinootologie. 1990;69(7):369–72. CAS Article Google Scholar Download references Author information Affiliations Department of Rehabilitation Medicine, Chengdu Second People's Hospital, No. 10 Qingyunnan Street, Jinjiang District, Chengdu, 610017, Sichuan, China Tao Xiang, Yingyue Yang & Juan Li Department of Neurology, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China Feng Wang Corresponding author Correspondence to Tao Xiang. Ethics declarations Conflict of interest We declare no conflicts of interest. Informed Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Reprints and Permissions About this article Verify currency and authenticity via CrossMark Cite this article Xiang, T., Wang, F., Yang, Y. et al. A Rare Case of Dysphagia with Palatal Tremor. Dysphagia 36, 758–760 (2021). https://doi.org/10.1007/s00455-020-10185-0 Download citation Received 15 July 2020 Accepted 24 August 2020 Published 03 September 2020 Issue Date August 2021 DOI https://doi.org/10.1007/s00455-020-10185-0 Share this article Anyone you share the following link with will be able to read this content: Get shareable link Provided by the Springer Nature SharedIt content-sharing initiative Download PDF Sections Figures References Case Presentation Diagnosis Discussion Conclusion References Author information Ethics declarations Additional information Rights and permissions About this article Advertisement Over 10 million scientific documents at your fingertipsSwitch Edition Academic Edition Corporate Edition Home Impressum Legal information Privacy statement California Privacy Statement How we use cookies Manage cookies/Do not sell my data Accessibility FAQ Contact us Affiliate program Not logged in - 141.255.95.55 Not affiliated Springer Nature © 2022 Springer Nature Switzerland AG. 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Characteristics of Dysphagia Based on the Type of ALS

alwin shared this article with you from Inoreader Characteristics of Dysphagia Based on the Type of ALS in Korean Patients Evaluated Using Videofluoroscopic Study: A Retrospective Analysis Via Dysphagia In this study, videofluoroscopic swallowing study (VFSS) results of bulbar and spinal onset ALS patients were compared. VFSS results and revised ALS Functional Rating Scale (ALSFRS-R) score were also analyzed to assess the correlation between dysphagia and functional status of patients. ALS patients with swallowing difficulties who underwent VFSS were recruited retrospectively. Two oral, seven pharyngeal, and two esophageal components of VFSS were evaluated. An ALSRFRS-R bulbar subtype score  <  9 was used to divide the groups with severe bulbar symptoms. Total 109 Korean ALS patients (39 bulbar vs 70 spinal) were included. Bulbar ALS patients exhibited a significantly longer oral transit time (OTT) then spinal ALS patients, especially in severe bulbar patients with low ALSRFRS-R bu... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Implementation of Pediatric Flexible-Endoscopic Evaluation of Swallowing: A Systematic Review and Recommendations for Future Research

alwin shared this article with you from Inoreader Implementation of Pediatric Flexible-Endoscopic Evaluation of Swallowing: A Systematic Review and Recommendations for Future Research Via Dysphagia DiscussionNone of the included studies showed good methodological quality and a significant amount of data were missing; the review still offers a systematic basis for future research to close the serious gap in the area of pediatric FEES. A proposal is made for a minimum requirement for pediatric FEES protocols in scientific studies. (Source: Dysphagia) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.