Cargando…

Botulinum toxin injection combined with traditional swallowing rehabilitation improved cricopharyngeal dysfunction in neuromyelitis optica spectrum disorder: A case report

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune diseases of the central nervous system, and often influence optic nerve and medulla oblongata. Previous studies found out that brain abnormalities were not rare in these patients. Medulla oblongata (MO) was commonly involved and usually...

Descripción completa

Detalles Bibliográficos
Autores principales: He, Zitong, Zhao, Fei, Shan, Yilong, Dou, Zulin, Wen, Hongmei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9366393/
https://www.ncbi.nlm.nih.gov/pubmed/35968297
http://dx.doi.org/10.3389/fneur.2022.939443
_version_ 1784765554431623168
author He, Zitong
Zhao, Fei
Shan, Yilong
Dou, Zulin
Wen, Hongmei
author_facet He, Zitong
Zhao, Fei
Shan, Yilong
Dou, Zulin
Wen, Hongmei
author_sort He, Zitong
collection PubMed
description Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune diseases of the central nervous system, and often influence optic nerve and medulla oblongata. Previous studies found out that brain abnormalities were not rare in these patients. Medulla oblongata (MO) was commonly involved and usually located at dorsal part. Patients who diagnosed NMOSD with MO lesions were more likely to have dysphagia. Previous reports indicated that the symptoms and signs of NMOSD patients could be controlled after immunosuppressive therapy. This patient was a 49-year-old Asian woman presented with recurrent vomiting and diagnosed NMOSD with MO involvement. However, after immunotherapy in other hospital, she still suffered from dysphagia. She then came to our department and completed videofluoroscopic swallowing study (VFSS) and high-resolution pharyngeal manometry (HRPM). Her UES was not opening with aspiration and the UES residue pressure was higher than normal range, we figured that she had cricopharyngeal (CP) dysfunction. Then the SLP gave her traditional treatment, including catheter balloon dilation. But she failed improvement after treatment for 2 weeks. Then the clinicians decided to inject botulinum toxin (BTX) into her CP muscles, which needed specific location and appropriate dosage. Her UES residue pressure decreased after three times BTX injection. During this time, her SLP adjusted the treatment strategies based on her VFSS and HRM results. Combined BTX injection with traditional treatment, she can now eat food orally without restrictions. This case report we presented can provide treatment strategies for similar patients with dysphagia.
format Online
Article
Text
id pubmed-9366393
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-93663932022-08-12 Botulinum toxin injection combined with traditional swallowing rehabilitation improved cricopharyngeal dysfunction in neuromyelitis optica spectrum disorder: A case report He, Zitong Zhao, Fei Shan, Yilong Dou, Zulin Wen, Hongmei Front Neurol Neurology Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune diseases of the central nervous system, and often influence optic nerve and medulla oblongata. Previous studies found out that brain abnormalities were not rare in these patients. Medulla oblongata (MO) was commonly involved and usually located at dorsal part. Patients who diagnosed NMOSD with MO lesions were more likely to have dysphagia. Previous reports indicated that the symptoms and signs of NMOSD patients could be controlled after immunosuppressive therapy. This patient was a 49-year-old Asian woman presented with recurrent vomiting and diagnosed NMOSD with MO involvement. However, after immunotherapy in other hospital, she still suffered from dysphagia. She then came to our department and completed videofluoroscopic swallowing study (VFSS) and high-resolution pharyngeal manometry (HRPM). Her UES was not opening with aspiration and the UES residue pressure was higher than normal range, we figured that she had cricopharyngeal (CP) dysfunction. Then the SLP gave her traditional treatment, including catheter balloon dilation. But she failed improvement after treatment for 2 weeks. Then the clinicians decided to inject botulinum toxin (BTX) into her CP muscles, which needed specific location and appropriate dosage. Her UES residue pressure decreased after three times BTX injection. During this time, her SLP adjusted the treatment strategies based on her VFSS and HRM results. Combined BTX injection with traditional treatment, she can now eat food orally without restrictions. This case report we presented can provide treatment strategies for similar patients with dysphagia. Frontiers Media S.A. 2022-07-28 /pmc/articles/PMC9366393/ /pubmed/35968297 http://dx.doi.org/10.3389/fneur.2022.939443 Text en Copyright © 2022 He, Zhao, Shan, Dou and Wen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
He, Zitong
Zhao, Fei
Shan, Yilong
Dou, Zulin
Wen, Hongmei
Botulinum toxin injection combined with traditional swallowing rehabilitation improved cricopharyngeal dysfunction in neuromyelitis optica spectrum disorder: A case report
title Botulinum toxin injection combined with traditional swallowing rehabilitation improved cricopharyngeal dysfunction in neuromyelitis optica spectrum disorder: A case report
title_full Botulinum toxin injection combined with traditional swallowing rehabilitation improved cricopharyngeal dysfunction in neuromyelitis optica spectrum disorder: A case report
title_fullStr Botulinum toxin injection combined with traditional swallowing rehabilitation improved cricopharyngeal dysfunction in neuromyelitis optica spectrum disorder: A case report
title_full_unstemmed Botulinum toxin injection combined with traditional swallowing rehabilitation improved cricopharyngeal dysfunction in neuromyelitis optica spectrum disorder: A case report
title_short Botulinum toxin injection combined with traditional swallowing rehabilitation improved cricopharyngeal dysfunction in neuromyelitis optica spectrum disorder: A case report
title_sort botulinum toxin injection combined with traditional swallowing rehabilitation improved cricopharyngeal dysfunction in neuromyelitis optica spectrum disorder: a case report
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9366393/
https://www.ncbi.nlm.nih.gov/pubmed/35968297
http://dx.doi.org/10.3389/fneur.2022.939443
work_keys_str_mv AT hezitong botulinumtoxininjectioncombinedwithtraditionalswallowingrehabilitationimprovedcricopharyngealdysfunctioninneuromyelitisopticaspectrumdisorderacasereport
AT zhaofei botulinumtoxininjectioncombinedwithtraditionalswallowingrehabilitationimprovedcricopharyngealdysfunctioninneuromyelitisopticaspectrumdisorderacasereport
AT shanyilong botulinumtoxininjectioncombinedwithtraditionalswallowingrehabilitationimprovedcricopharyngealdysfunctioninneuromyelitisopticaspectrumdisorderacasereport
AT douzulin botulinumtoxininjectioncombinedwithtraditionalswallowingrehabilitationimprovedcricopharyngealdysfunctioninneuromyelitisopticaspectrumdisorderacasereport
AT wenhongmei botulinumtoxininjectioncombinedwithtraditionalswallowingrehabilitationimprovedcricopharyngealdysfunctioninneuromyelitisopticaspectrumdisorderacasereport