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[Dysphagia] curious patient possible als diagnosis TBA
Kim,
Could you characterize dysarthria (spastic, flaccid, mixed flaccid spastic)?
What about tongue fasciculations?
What about hypernasality
What is voice quality (strained/strangled)?
If you're not familiar with motor speech workup, refer to Duffy's Motor
Speech Disorders. You should be able to ascertain type of dysarthria so docs
have something more to go on.
Woodford A. Beach, PhD, CCC/SP
Senior Speech-Language Pathologist
Adjunct Assistant Professor, Neurology and PM&R
VCU Medical Center
----- Original Message -----
From: "Irene Campbell-Taylor" <eripley@yahoo.com>
To: "Clarke-Goertz, Kim (PAPHR)" <kgoertz@paphr.sk.ca>; "'Dysphagia listserv
(E-mail)'" <dysphagia@b9.com>
Sent: Thursday, September 30, 2004 3:15 PM
Subject: Re: [Dysphagia] curious patient possible als diagnosis TBA
"Clarke-Goertz, Kim (PAPHR)" <kgoertz@paphr.sk.ca> wrote:
I am beginning assessment with a gentleman with a queried diagnosis of ALS.
I was asked to see him d/t dysphagia and dysarthria. Pt. has definite oral
stage dysphagia (worse anteriorly) with copious saliva. Hydration is
reported to be good. His diet has been modified well at home to accomodate
difficulties (slurried/liquified puree).
***When did this begin?
They are:
nimotop
*** This is for subarachnoid hemhorrage or migraine. Why is he on it?
amytriptyline (to dry up saliva)
*** This antidepressant is known as a "dirty" drug with many adverse side
effects.
zopiclone
*** For insomnia. Why?
minocycline
*** Now this one......
CNS toxicity and adverse CNS effects (e.g., vestibular reactions) occur more
frequently with minocycline than with other currently available
tetracyclines (antibiotic) . The true incidence of these has not been
determined. Previously, vestibular symptoms were reported to occur in up to
21% of patients treated with minocycline. However, recent studies indicate
that these reactions may occur in 30-90% of patients treated with usual
dosages of minocycline.
***What are his eye signs like? Any tongue atrophy?
Irene.
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
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