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[DYSPHAGIA] xerostomia
- Subject: [DYSPHAGIA] xerostomia
- From: rayhagan@msn.com (rayhagan)
- Date: Sun, 25 Nov 2001 21:02:41 -0800
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I just completed an MBS on a 50 + y/o patient who has experienced =
several "TIAs", the most recent in June. She has experienced a change =
in voice and complains of difficulty swallowing with pills sticking and =
similar symptoms with food at times. On occasion she begins to cough =
without anything in her mouth at all. I was unable to stimulate a gag =
reflex and her mouth seemed extraordinarily dry - another complaint that =
she voices which she attributes to an antidepressant she takes. There =
was no oral weakness or assymetry. The MBS demonstrated flash =
penetration with initial trials of thin fluid which cleared =
spontaneously. Later in the eval penetration did not occur. What was =
remarkable was how food stuck in the pharyngeal area above, in and below =
the vallecula. With repeated swallows she was able to eventually clear =
these boluses, but had most difficulty with dry food. I'm wondering if =
anyone has any experience with xerostomia and if it could be so severe =
that it would produce this kind of dysphagia. It looks as though her =
tongue base makes contact with the pharyngeal wall. If that didn't =
occur I would be more likely to think it was decreased tongue base =
strength.. I'm wondering if anyone has any experience with xerostomia =
and if it could be so severe that it would produce this kind of =
dysphagia? What about voice changes? Or should I be looking more =
closely at neurologic causes? Thanks lh=20
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<DIV><FONT size=3D2>I just completed an MBS on a 50 + y/o patient who =
has=20
experienced several "TIAs", the most recent in June. She has =
experienced a=20
change in voice and complains of difficulty swallowing with pills =
sticking and=20
similar symptoms with food at times. On occasion she begins to =
cough=20
without anything in her mouth at all. I was unable to stimulate a =
gag=20
reflex and her mouth seemed extraordinarily dry - another complaint that =
she=20
voices which she attributes to an antidepressant she takes. There =
was no=20
oral weakness or assymetry. The MBS demonstrated flash penetration =
with=20
initial trials of thin fluid which cleared spontaneously. Later in =
the=20
eval penetration did not occur. What was remarkable was how food =
stuck in=20
the pharyngeal area above, in and below the vallecula. With =
repeated=20
swallows she was able to eventually clear these boluses, but had =
most=20
difficulty with dry food. I'm wondering if anyone has any =
experience with=20
xerostomia and if it could be so severe that it would produce this =
kind of=20
dysphagia. It looks as though her tongue base makes contact with =
the=20
pharyngeal wall. If that didn't occur I would be more likely to =
think it=20
was decreased tongue base strength.. I'm wondering if anyone has =
any=20
experience with xerostomia and if it could be so severe that it =
would=20
produce this kind of dysphagia? What about voice =
changes? Or=20
should I be looking more closely at neurologic causes? Thanks=20
lh </FONT></DIV></BODY></HTML>
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