[DYSPHAGIA] cricopharyngeal spasms

[vstefans@care.ach.uams.edu (Vikki A. Stefans)]

I thought crico- spasm required a work up for gastritis/esophagitis and
GER first?  Level of localization of symptoms is often (or maybe usually)
wrong.  (if anyone has that reference really handy, or the stats from it,
I'd appreciate- could use it for a presentation I have to redo.) Two
months of dysphagia therapy would *not* be my first therapeutic or
diagnostic maneuver in this situation!  A progressive swallowing disroder,
if it is not GI or medication related, (high dose baclofen, e.g.) would
require a search for a cervicomeduallry syrinx, as it should not be
worsening just related to the static spinal cord injury.

(PS for that presentation- a few years ago, ther was this dysphagia web
site that had an animation of a swallow on the main page- I could really
really use that to make a teaching point, it actually had the esophagus
anterior to the trachea!  If anyone has it and it can be shared, I would
love it and I would not necessarily say where it was from if anyone was
embarrassed.)  

TIA,

Vikki Stefans, pediatric physiatrist (rehab doc for kids), e-mail junkie, 
working Mom of Sarah T. and Michael C., and wife of Henry "My Travel Agent", 
Arkansas Children's Hospital/ U of A for Medical Sciences, Little Rock, aka
vstefans@care.ach.uams.edu ...and EVERY mom is a working mom! (OK, dads too.) 


On Thu, 8 Mar 2001, Larry/Pam Seibert wrote:

> Am scheduled to see a quadraplegic tomorrow who is on a cuffless trach
> and was recently scoped because he started having trouble swallowing
> solids.  He complained that there was difficulty at the level of the
> trach.  He was on a regular diet for years prior to this.
> 
> When scoped the physician ordered 2 months of speech therapy to
> strengthen the swallow before considering a myotomy.  A spasm was noted
> at the level of the cricophayngus.
> 
> I haven't done much of this before and would appreciate anyone's advice
> on such a case.
> 
> Pam
> 
> ---------------------------------------------------------------------
> To UNSUBSCRIBE from this list, please send an e-mail message to
> majordomo@medonline.com with the following text as a message:
> unsubscribe dysphagia
> ---------------------------------------------------------------------
> 

---------------------------------------------------------------------
To UNSUBSCRIBE from this list, please send an e-mail message to
majordomo@medonline.com with the following text as a message:
unsubscribe dysphagia
---------------------------------------------------------------------