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[Dysphagia] spinal cord compression


  • Subject: [Dysphagia] spinal cord compression
  • From: eripley at yahoo.com (Irene Campbell-Taylor)
  • Date: Sun Jan 18 21:24:10 2004
  • In-reply-to: <59.36308dc.2d3cb20f@aol.com>


Aegna@aol.com wrote:

Recently met a pt with lung ca (no prior treatment)
that has metastasized to spinal cord.  He is now unable to move
lower extremities.    He is complaining of dysphagia (solids
and liquids) and persistent dryness of mouth and throat. 

Xerostomia will by itself, disrupt the coodination of the swallow but there are other issues here:

 His voice
sounds very breathy and soft.  Recent laryngoscopy showed
"inflammation around vocal folds." 

Most probably laryngopharyngeal reflux:

On bedside eval, he is struggling
on minimal amounts of both semi-solid and liquid (multiple swallows, etc)
and clearing/coughing on all liqs. 

The most frequent cause of deglutition disorder in a case such as you describe is paraneoplastic syndrome affecting the cerebellum. In addition, the GERD that appears to be present will affect the oropharyngeal swallow to some degree as will the xerostomia. There are other, less likely explanations. Management is palliative.



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