[Dysphagia] Olivopontocerebellar atrophy

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

Having done extensive research on dysphagia in Olivopontocerebellar atrophy  types 1,2 and 3 over several years, I feel very strongly about this issue.  What you describe is typical- lung abscess due to inhalation of piece(s) of food. None of the research subjects I saw over many years developed pneumonia and ALL refused enteral feeding with the family's agreement.  The cause of death was almost always pneumonia but only after significant weight loss and reduction of immune response. In my experience, enteral feeding is not required and may very well do more harm than good. I had one subject who was admitted to hospital after inhaling a piece of carrot (and hot dogs are not unusual dietary items, by the way) and developing ARDS. She was ventilated and tube fed until she discharged herself. When I saw her at home a year later she was breathing normally, eating and drinking a normal diet - although I would have preferred that she skip the hot dogs. It must be borne in mind
 that as in MS and similar diseases, SCA carries a frontal type dementia that involves poor judgment and insight so it is the family members who must make decisions. Please let me know if you require any more information.

Dr I Campbell-Taylor
Clinical Neuroscientist
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