[Dysphagia] Yawning

[eripley at yahoo.com (Irene Campbell-Taylor)]

--- TIAFAMILY@aol.com wrote:

> Approximately 9-10 mos. ago,  he 
> began "scraping" his tongue with the toothbrush per
> the instruction of  his 
> dental hygienist.  He reports that since that time,
> when he  yawns, he is unable to 
> exhale air effectively.  

***As most experienced clinicians are aware, the onset
of various disorders is often ascribed to an unrelated
event in the patient?s mind. That may be the case here
and I would wondr if this gentleman has other, subtle
signs and symptoms that are not as obvious as the
inhibition of yawning. A great deal of investigation
has been done on yawning and Parkinson disease.Yawning
 is most likely a dopamine-mediated phenomenon, evoked
by stimulation of dopamine D2-receptors. Yawning
induced by dopamine receptor agonists is potentiated
by decreases in serotonergic neuron activity. Yawning
is under the control of several neurotransmitters and
neuropeptides . Among these substances, the best known
are dopamine, excitatory amino acids, acetylcholine,
serotonin, nitric oxide, adrenocorticotropic
hormone-related peptides and oxytocin, that facilitate
yawning and opioid peptides that inhibit it. Some of
the above compounds interact in the paraventricular
nucleus of the hypothalamus to control yawning. This
hypothalamic nucleus contains the cell bodies of
oxytocinergic neurons projecting to extra-hypothalamic
brain areas that play a key role in yawning. When
activated by dopamine, excitatory amino acids and
oxytocin itself, these neurons facilitate yawning by
releasing oxytocin at sites distant form the
paraventricular nucleus, i.e. the hippocampus, the
pons and/or the medulla oblongata. Conversely,
activation of these neurons by dopamine, oxytocin or
excitatory amino acids, is antagonized by opioid
peptides, that, in turn, prevent the yawning response.
Of course, I am not suggesting that he be told that he
may have a neurological disease but there are some
things I would wonder about: is he taking any
psychotropic medication that he might not be willing
to talk about, is he taking Viagra (same problem re
disclosure and if anyone wants to know the
relationship please ask me privately), has he noticed
any other subtle behavioral or physical changes. I
would certainly encourage him to get a full checkup on
the basis that this is an unusual response that may be
related to something else. A very delicate situation,
I grant, but not one I would be happy about ignoring.
Irene.
 	





=====
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com