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[Dysphagia] spasmodic dysphonia
- Subject: [Dysphagia] spasmodic dysphonia
- From: pressmah at sjhmc.org (Pressman, Hilda)
- Date: Tue Jun 27 12:13:49 2006
Perhaps GI should take a look. If they don't find anything she have a traumatic dysphagia secondary to possibly some difficulty following the botox and fear of swallowing now Hilda Pressman
-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]On
Behalf Of Jonathan Bennett
Sent: Tuesday, June 27, 2006 10:18 AM
To: dysphagia@b9.com
Subject: [Dysphagia] spasmodic dysphonia
Any suggestions would be appreciated....
The patient is a 57 yr old woman who had Botox injections 2 weeks ago for adductor spasmodic dysphonia. Prior to these injections she had NO swallowing difficulties. She was sent to me from the ENT to get a video done to r/o aspiration (this is 2 weeks s/p injection) since the patient was refusing to eat and the family was stating that she was throwing it all back up. She came to me on IVF. During the video, she was given nectar and thin liquids. No aspiration was seen with these trials, yet the patient began to gag and try to vomit as well as "cough" following each trial of liquid. She had long periods of doing this following each trial, so much so that she became short of breath (granted she hasn't eaten for 2 weeks). Another point to add was that she held the liquid in her mouth for at least 10 seconds before swallowing, as if afraid to swallow (it was difficult to assess why since the patient only spoke Spanish). No additional trials were given. The
radiologist also saw some reversed esophageal peristalsis. Following the video, she had an appointment at the ENT at which time he sent her to the ER....this is the point I am at now. I was re-consulted with her, now as an inpatient. I went in to see her today and gave her very small amounts water on a swab. Before even swallowing or gaining much liquid off of the swab, she began to gag and "cough". I has spoken with 3 doctors in r/t this case and none can seem to explain what is going on....ANY suggestions on the cause of the dysphagia directions to go in would be greatly appreciated.
Thank you.
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