Screening and evaluation tools of dysphagia in children with neuromuscular diseases: a systematic review

Audag, Nicolas; Goubau, Christophe; Toussaint, Michel; Reychler, Grégory

doi:10.1111/dmcn.13354

Cited by 34 publications

(27 citation statements)

References 71 publications

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“…A recent systematic review of dysphagia in children focused primarily on boys with DMD; there was a lack of widely accepted screening or evaluation protocol for other pediatric neuromuscular disorders. 61 Boys with DMD were found to have progressive involvement of the oropharyngeal muscles, necessitating the modification of feeding strategies to minimize dysphagia. 62 As transporting and swallowing requires the use of more than 25 pairs of oral and masticatory muscles that are difficult to be assessed by EMG, van den Engel-Hoek et al 63 proposed to use muscle ultrasound as a standard diagnostic tool for the assessment of dysphagia ( Figures 8A-8B), based on their extensive experience with ultrasound in the neuromuscular population.…”

Section: Assessing Muscles That Cannot Be Easily Accessed With Emgmentioning

confidence: 99%

Neuromuscular Ultrasound: Clinical Applications and Diagnostic Values

Mah

Alfen

2018

Can. J. Neurol. Sci.

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Advances in high-resolution ultrasound have provided clinicians with unique opportunities to study diseases of the peripheral nervous system. Ultrasound complements the clinical and electrophysiology exam by showing the degree of abnormalities in myopathies, as well as spontaneous muscle activities in motor neuron diseases and other disorders. In experienced hands, ultrasound is more sensitive than MRI in detecting peripheral nerve pathologies. It can also guide needle placement for electromyography exam, therapeutic injections, and muscle biopsy. Ultrasound enhances the ability to detect carpal tunnel syndrome and other focal nerve entrapment, as well as pathological nerve enlargements in genetic and acquired neuropathies. Furthermore, ultrasound can potentially be used as a biomarker for muscular dystrophy and spinal muscular atrophy. The combination of electromyography and ultrasound can increase the diagnostic certainty of amyotrophic lateral sclerosis, aid in the localization of brachial plexus or peripheral nerve trauma and allow for surveillance of nerve tumor progression in neurofibromatosis. Potential limitations of ultrasound include an inability to image deeper structures, with lower sensitivities in detecting neuromuscular diseases in young children and those with mitochondrial myopathies, due to subtle changes or early phase of the disease. As well, its utility in detecting critical illness neuromyopathy remains unclear. This review will focus on the clinical applications of neuromuscular ultrasound. The diagnostic values of ultrasound for screening of myopathies, neuropathies, and motor neuron diseases will be presented.

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Section: Assessing Muscles That Cannot Be Easily Accessed With Emgmentioning

confidence: 99%

Neuromuscular Ultrasound: Clinical Applications and Diagnostic Values

Mah

Alfen

2018

Can. J. Neurol. Sci.

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“…Swallowing difficulty is frequently encountered, especially in children with underlying diseases. According to previous studies, swallowing disorders have been reported in 43%–100% of children with cerebral palsy [ 1 2 ] and 35%–80% of children with neuromuscular disease [ 3 ]. Swallowing difficulty may lead to life-threatening conditions, such as aspiration pneumonia (AP), asphyxia, and sepsis.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Videofluoroscopic Swallowing Study and Radionuclide Salivagram for Aspiration Pneumonia in Children With Swallowing Difficulty

Kim

Sung

et al. 2018

Ann Rehabil Med

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ObjectiveTo determine whether the use of both videofluoroscopic swallowing study (VFSS) and radionuclide salivagram was beneficial for detecting aspiration-induced pneumonia in children with swallowing difficulty.MethodsFrom 2001 to 2016, children who underwent both VFSS and salivagram consecutively for suspected aspiration or dysphagia were included in the study. Demographic data, findings of VFSS and salivagram, and medical records were reviewed.ResultsAspiration pneumonia (AP) was present in 34 out of 110 children; 48 showed positive aspiration findings in VFSS and 33 showed positive aspiration findings in salivagram. Among the 62 children who were negative of aspiration in VFSS, 12 (19.4%) showed positive aspiration findings in salivagram. Four out of 12 children were diagnosed with AP. The aspiration findings in both VFSS and salivagram were significantly related to AP. However, the aspiration findings in the two tests were weakly consistent. Even if one test showed negative aspiration, it was helpful to additionally detect AP using another test, which showed positive aspiration finding. If aspiration findings were positive in only one of the two tests, the probability of AP was 38.5%, whereas if they were positive in both tests, the probability increased to 66.7%. If the aspiration findings were negative in both tests, AP did not occur with a probability of 90%.ConclusionSalivagram is a valuable tool for monitoring of aspiration in children with swallowing difficulties. It could be helpful in assessment of children at a high risk of AP, even if the VFSS showed negative aspiration findings. Thus, testing for AP using both VFSS and salivagram is desirable.

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“…The patients usually develop with motor gain, however, scoliosis, respiratory and bulbar involvement commonly appear in the first decade [3] . Bulbar weakness is found ubiquitously throughout all disease spectrums; however, the precise prevalence is underestimated due to the lack of standardized evaluation tools, especially in children [38] . A previous NHS found that 52% of the ACTA1 and 57% of the NEB patients presented bulbar weakness [5] , highlighting how frequent and important this feature is across this patient population.…”

Section: Clinical Outcome Measuresmentioning

confidence: 99%

“…The formal evaluation of bulbar weakness is challenging. Early signs such as weak cough, failure to thrive, difficulty to gain weight and long meal duration are often discreet and can be masked by other symptoms [38] . There is no validated clinical assessment for evaluating bulbar weakness in congenital myopathies, but tests validated for other neuromuscular diseases like the SLURP test 39] , the Sidney Swallowing Questionnaire (SSQ), [40] and the Neuromuscular Disease Swallowing Status Scale (NdSSS) [41] may be helpful in assessing patients with NM as well.…”

Section: Clinical Outcome Measuresmentioning

confidence: 99%