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[Dysphagia] FW: Brainstem stroke
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Philip
The reason I asked about chickenpox is because of the possibility of varicella encephalitis - the rash is extremely important in the differential and wouldn't necessarily be associated with a stroke whereas a viral encephalitis might.
If Cr IX, X, XI and XII are involved, it's even more likely, as a possible Collet-Sicard syndrome.
But I'd check infections - viral bacterial- first, then meds.
Philip Beck <r3pbeck@health.nb.ca> wrote:
-----Original Message-----
From: Beck, Phillip
Sent: Tuesday, September 30, 2003 12:02 PM
To: 'KELLY REYNOLDS'; ', dysphagia@b9.com '
Subject: RE: Brainstem stroke
Thanks Kelly. A brain stem infarct is my "provisional dx" as well. Like you
that is what my experience would indicate, but in the past there have
usually been other neuro signs. Do you have the citation for that article by
any chance? Although I did not do the MBS myself the consistencies that my
colleague tried were; thin, nectar, and soft (she indicates a ripe banana,
but doesn't say if it was mashed or whole). This patient also had no
awareness of the residue also suggestive of a BS strike. Philip
-----Original Message-----
From: KELLY REYNOLDS [SMTP:kwreynol@gbmc.org]
Sent: Tuesday, September 30, 2003 10:44 AM
To: Beck, Phillip
Subject: Re: Brainstem stroke
Having worked extensively with brainstem stroke, I would
think that is
the source of your patient's problems. There was an article
several
years ago out of JHH that clearly documented sudden onset of
dysphagia
w/o evidence on CT/MRI.
Dr. Jeffrey Palmer at JHH is a specialist at brainstem. I
have worked
with him extensively. If you want some other ideas, respond
to this and
I would be glad to help you out. Let me know what
consistencies you
gave on the mbs and I will give you some ideas for
treatment.
I'm leaving for Dysphagia Research Society tomorrow, so
respond by
today or I will get back to your next week.
Kelly
Kelly W. Reynolds MS CCC-SLP
Senior Speech Language Pathologist
Milton Dance Head & Neck Rehabilitation Center
Greater Baltimore Medical Center
Office: 443-849-2087
Pager: 443-849-3135 pager # 366
kwreynol@gbmc.org
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<DIV>Philip</DIV>
<DIV>The reason I asked about chickenpox is because of the possibility of varicella encephalitis - the rash is extremely important in the differential and wouldn't necessarily be associated with a stroke whereas a viral encephalitis might.</DIV>
<DIV>If Cr IX, X, XI and XII are involved, it's even more likely, as a possible Collet-Sicard syndrome.</DIV>
<DIV>But I'd check infections - viral bacterial- first, then meds.<BR><BR><B><I>Philip Beck <r3pbeck@health.nb.ca></I></B> wrote:</DIV>
<BLOCKQUOTE class=replbq style="PADDING-LEFT: 5px; MARGIN-LEFT: 5px; BORDER-LEFT: #1010ff 2px solid"><BR><BR>-----Original Message-----<BR>From: Beck, Phillip <BR>Sent: Tuesday, September 30, 2003 12:02 PM<BR>To: 'KELLY REYNOLDS'; ', dysphagia@b9.com <mailto:dysphagia@b9.com>'<BR>Subject: RE: Brainstem stroke<BR><BR>Thanks Kelly. A brain stem infarct is my "provisional dx" as well. Like you<BR>that is what my experience would indicate, but in the past there have<BR>usually been other neuro signs. Do you have the citation for that article by<BR>any chance? Although I did not do the MBS myself the consistencies that my<BR>colleague tried were; thin, nectar, and soft (she indicates a ripe banana,<BR>but doesn't say if it was mashed or whole). This patient also had no<BR>awareness of the residue also suggestive of a BS strike. Philip<BR><BR>-----Original Message-----<BR>From: KELLY REYNOLDS [SMTP:kwreynol@gbmc.org]<BR><mailto:[SMTP:kwreynol@gbmc.org]><BR>Sent: Tuesday, September 30, 2003
10:44 AM<BR>To: Beck, Phillip<BR>Subject: Re: Brainstem stroke<BR><BR>Having worked extensively with brainstem stroke, I would<BR>think that is<BR>the source of your patient's problems. There was an article<BR>several<BR>years ago out of JHH that clearly documented sudden onset of<BR>dysphagia<BR>w/o evidence on CT/MRI.<BR><BR>Dr. Jeffrey Palmer at JHH is a specialist at brainstem. I<BR>have worked<BR>with him extensively. If you want some other ideas, respond<BR>to this and<BR>I would be glad to help you out. Let me know what<BR>consistencies you<BR>gave on the mbs and I will give you some ideas for<BR>treatment.<BR><BR>I'm leaving for Dysphagia Research Society tomorrow, so<BR>respond by<BR>today or I will get back to your next week.<BR><BR>Kelly <BR><BR>Kelly W. Reynolds MS CCC-SLP<BR>Senior Speech Language Pathologist<BR>Milton Dance Head & Neck Rehabilitation Center<BR>Greater Baltimore Medical Center<BR>Office: 443-849-2087<BR>Pager: 443-849-3135 pager #
366<BR>kwreynol@gbmc.org <mailto:kwreynol@gbmc.org><BR><BR><BR><BR><BR><BR><BR>****************************************************************************<BR>**********************<BR>This email may contain confidential protected health<BR>information and/or proprietary information belonging to the sender that is<BR>legally privileged under local, state, or federal law. This information is<BR>intended only for the use of the individual or individuals who have received<BR>this. The authorized recipient of this information is prohibited from<BR>disclosing this information to any other party unless required to do so by<BR>law. If you are not the intended recipient, you are hereby notified that any<BR>disclosure, copying, distribution, or action taken in reliance on the<BR>contents of this email is strictly prohibited. If you have received this<BR>email in error, please notify the sender immediately to arrange for the<BR>disposal of this
information.<BR><BR><BR>****************************************************************************<BR>**********************<BR><BR>_______________________________________________<BR>Dysphagia mailing list<BR>Dysphagia@b9.com<BR>http://lists.b9.com/mailman/listinfo/dysphagia</BLOCKQUOTE></mailto:kwreynol@gbmc.org></mailto:[SMTP:kwreynol@gbmc.org]></mailto:dysphagia@b9.com><BR><BR>Dr I Campbell-Taylor<br>Clinical Neuroscientist<br>Exclusive Distributor:<br>www.interactivetherapy.com
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