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[Dysphagia] GBS and exercises



You could possibly try e-stim or SEMG if you have access to this equipment.
I'm yet to use these in my clinical setting but we are aiming to begin a
trial so not sure of the effectiveness as yet.  

Sarah Whitney
Deputy Head of Department
Speech Pathology 
Royal Prince Alfred Hospital
Ph:(02)9515 9803
Fax:(02)9515 9255
Switchboard:(02)9515 6111 pager 81112

-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On Behalf
Of Sharon Manders
Sent: Wednesday, February 08, 2006 8:56 AM
To: dysphagia@b9.com
Subject: [Dysphagia] GBS and exercises

Hello,

I have a new pt - 38 yr old female. An oral motor assessment revealed
little/no function CN VII and reduced CN XII (left only). She
basically has no movement of anything above her bottom lip. Her
swallowing is fine, she has naturally some trouble holding a straw
effectively but compensates somewhat with her bottom lip. The
neurologist told me that it might take approx 3 months to regenerate
the nerves, as her GBS was so severe that the axons are likely
damaged, but exercises are not contraindicated. Also, apart from her
initial presentation, she developed the facial/oral motor weakness
after being in hospital for a few days. Original onset was approx 1
month ago. Her trach was removed yesterday and her vocal quality and
strength are very good.

My main question is: are there any exercises that I should be trying?
I gave her some to try to work on her lips and cheeks (puffing out
cheeks, trying to open and close her lips against the pressure of her
fingers, etc.) She still cannot close her eyes completely and is
receiving artificial tears p.r.n. She is highly motivated, English
speaking and cognitively intact. I don't do much treatment at all, but
would like to do something for this lady. I realize that spontaneous
recovery will play a big part, but is there anything I can do to help
it along?

Many thanks in advance,

Sharon

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