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Pharyngeal Dystonia Misdiagnosed as Cricopharyngeal Dysphagia Successfully Treated by Pharmacotherapy

A 43-year-old woman suffered from drooling and dysphagia after a stroke in the left posterior inferior cerebellar artery territory. Videofluoroscopic swallowing study showed compatible findings of cricopharyngeal dysphagia. Despite the injection of botulinum neurotoxin, no symptom improvement was ac...

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Autores principales: Park, Ho Eun, Shin, Myung Jun, Lee, Je-Sang, Shin, Yong Beom
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Academy of Rehabilitation Medicine 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6960087/
https://www.ncbi.nlm.nih.gov/pubmed/31918534
http://dx.doi.org/10.5535/arm.2019.43.6.720
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author Park, Ho Eun
Shin, Myung Jun
Lee, Je-Sang
Shin, Yong Beom
author_facet Park, Ho Eun
Shin, Myung Jun
Lee, Je-Sang
Shin, Yong Beom
author_sort Park, Ho Eun
collection PubMed
description A 43-year-old woman suffered from drooling and dysphagia after a stroke in the left posterior inferior cerebellar artery territory. Videofluoroscopic swallowing study showed compatible findings of cricopharyngeal dysphagia. Despite the injection of botulinum neurotoxin, no symptom improvement was achieved and pharyngeal dystonia was considered as the cause. Medications for dystonia dramatically helped with saliva control and resulted in a small improvement in the progression of food from the pharyngeal to esophageal phase. After adjusting the drug dose, the patient was able to perform social activities without drooling. Moreover, she could consume food orally; however, this was limited to small amounts of liquid, and the main method of nutrition support was via an orogastric tube. Therefore, we suggest that physicians should make a differential diagnosis of combined dystonia in patients complaining of dysphagia by esophageal manometry and electromyography.
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spelling pubmed-69600872020-01-22 Pharyngeal Dystonia Misdiagnosed as Cricopharyngeal Dysphagia Successfully Treated by Pharmacotherapy Park, Ho Eun Shin, Myung Jun Lee, Je-Sang Shin, Yong Beom Ann Rehabil Med Case Report A 43-year-old woman suffered from drooling and dysphagia after a stroke in the left posterior inferior cerebellar artery territory. Videofluoroscopic swallowing study showed compatible findings of cricopharyngeal dysphagia. Despite the injection of botulinum neurotoxin, no symptom improvement was achieved and pharyngeal dystonia was considered as the cause. Medications for dystonia dramatically helped with saliva control and resulted in a small improvement in the progression of food from the pharyngeal to esophageal phase. After adjusting the drug dose, the patient was able to perform social activities without drooling. Moreover, she could consume food orally; however, this was limited to small amounts of liquid, and the main method of nutrition support was via an orogastric tube. Therefore, we suggest that physicians should make a differential diagnosis of combined dystonia in patients complaining of dysphagia by esophageal manometry and electromyography. Korean Academy of Rehabilitation Medicine 2019-12 2019-12-31 /pmc/articles/PMC6960087/ /pubmed/31918534 http://dx.doi.org/10.5535/arm.2019.43.6.720 Text en Copyright © 2019 by Korean Academy of Rehabilitation Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Park, Ho Eun
Shin, Myung Jun
Lee, Je-Sang
Shin, Yong Beom
Pharyngeal Dystonia Misdiagnosed as Cricopharyngeal Dysphagia Successfully Treated by Pharmacotherapy
title Pharyngeal Dystonia Misdiagnosed as Cricopharyngeal Dysphagia Successfully Treated by Pharmacotherapy
title_full Pharyngeal Dystonia Misdiagnosed as Cricopharyngeal Dysphagia Successfully Treated by Pharmacotherapy
title_fullStr Pharyngeal Dystonia Misdiagnosed as Cricopharyngeal Dysphagia Successfully Treated by Pharmacotherapy
title_full_unstemmed Pharyngeal Dystonia Misdiagnosed as Cricopharyngeal Dysphagia Successfully Treated by Pharmacotherapy
title_short Pharyngeal Dystonia Misdiagnosed as Cricopharyngeal Dysphagia Successfully Treated by Pharmacotherapy
title_sort pharyngeal dystonia misdiagnosed as cricopharyngeal dysphagia successfully treated by pharmacotherapy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6960087/
https://www.ncbi.nlm.nih.gov/pubmed/31918534
http://dx.doi.org/10.5535/arm.2019.43.6.720
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