[Dysphagia] loss of consciousness while swallowing in SCI vent depend pt

[vstefans at george.ach.uams.edu (Vikki Stefans)]

Possibly just reflux and a vagal reaction?

Also, with very high quadriplegia, possibly this triggers autonomic
dysreflexia and bradycardia also. What are his BP and heart rate when this
happens?

Vikki Stefans, M.D., pediatric physiatrist (rehab doc for kids) at UAMS
and Arkansas Children's Hospital.  Working Mom of Sarah T. and Michael C.,
and wife of Henry Stefans. Every mom is a working mom!- OK, dads too.

On Tue, 14 Dec 2004 mcronen@comdis.umass.edu wrote:

> I have just received a consult for a swallowing evalution for a 74 yo
> C2-4 vent dependent gentleman with spinal cord injury who fell off roof
> in 1999. In the past month there have been several epidosdes of
> decreased level of ability to swallow. Wife reports the following:
> Patient is currently on a pureed diet which wife mixes herself. Patient
> will have a small amount of bolus of food in his mouth and after 3-4
> spoonfuls, he has decreased ability to swallow, he then goes into a near
> trance with a decreased level of consciousness. There is no volunatry or
> involuntary choking at this time. After several hours , patient produces
> a whitish bubbly liquid from his mouth. He then sleeps deeply the
> remainder of the day. His body temp reduces that evening to around 90 or
> 91 degrees. This has happened 3 times in the past month.  Any ideas why
> this occurs. Any suggestions what to look for or ask about? I don't know
> if this behavior is only triggered when eating. Any help would be
> appreciated.