Dysphagia in adult myopathies

Abstract

Dysphagia (impaired swallowing) is not a rare problem in various neuromuscular disorders, both in the pediatric and the adult patient population. On many occasions such patients are first presented to other medical specialists or health professionals. Disorders of deglutition are probably underrecognized in patients with a neuromuscular disease as a result of patient's and doctor's delay.This review will focus on dysphagia in adults suffering from a myopathy. Dysphagia in myopathies usually affects the oropharyngeal phases which rely mostly on voluntary muscle activity of the mouth, pharynx and upper esophageal sphincter. Dysphagia is known to contribute to a reduction of quality of life and may also lead to increased morbidity and mortality. The review includes an overview on symptomatology and tools of assessments, and elaborates on dysphagia in specific hereditary and acquired myopathies.

Impact of dysphagia and its severity on long‐term survival and swallowing function outcomes in patients with idiopathic inflammatory myopathies other than inclusion body myositis

“…There are numerous modes of dysphagia diagnostic and severity assessment measures, including patient-reported outcome tools and related questionnaires, bedside testing, instrumental methods, and imaging. 30,31 Fiber-optic endoscopic evaluation of swallowing and videofluoroscopic swallowing studies are widely used for the objective assessment of dysphagia, regardless of the underlying disease. As patient-reported outcomes for dysphagia in IIM patients, various assessment methods have been used, such as EAT-10, swallowing quality of life (SWAL-QOL), and MD Anderson dysphagia inventory.…”

“…As patient-reported outcomes for dysphagia in IIM patients, various assessment methods have been used, such as EAT-10, swallowing quality of life (SWAL-QOL), and MD Anderson dysphagia inventory. [31][32][33] FILS is a simple and quantitative method to evaluate the severity of dysphagia based on the route of nutritional intake and the food form without using instrumental swallowing tests or questionnaires. It has been widely used in Japan to assess dysphagia from various background diseases.…”

“…There are numerous modes of dysphagia diagnostic and severity assessment measures, including patient‐reported outcome tools and related questionnaires, bedside testing, instrumental methods, and imaging 30,31 . Fiber‐optic endoscopic evaluation of swallowing and videofluoroscopic swallowing studies are widely used for the objective assessment of dysphagia, regardless of the underlying disease.…”

“…Fiber‐optic endoscopic evaluation of swallowing and videofluoroscopic swallowing studies are widely used for the objective assessment of dysphagia, regardless of the underlying disease. As patient‐reported outcomes for dysphagia in IIM patients, various assessment methods have been used, such as EAT‐10, swallowing quality of life (SWAL‐QOL), and MD Anderson dysphagia inventory 31–33 …”

Neuromuscular disease pearl: Don't overlook the swallow

“…In essence, the swallow mechanism can be divided into three separate phases, 3,10 which constitute the oral (horizontal), pharyngeal, and esophageal (vertical) processes. The oral phase is predominantly volitional in nature, whereas the pharyngeal and esophageal phases are primarily under reflex control.…”