[Diagnosis and treatment of dysphagia in patients with neuromuscular disease]. / Schluckstörungen bei neuromuskulären Erkrankungen erkennen und behandeln.

ABSTRACT

Dysphagia is a risk factor for pneumonia in patients with neuromuscular disease (NMD). The management of dysphagia influences respiratory complications and prognosis in NMD. Early symptoms of dysphagia are often discrete. There may be symptoms like change of voice ("wet voice") or dyspnea following a meal, or weight loss. Fiberoptic flexible endoscopic evaluation of swallowing (FEES) and videofluoroscopy are important diagnostic tools in the work-up of dysphagia. FEES should be performed with different nourishments like fluid (water), pulp, normal meal and dry cookies. The therapy for swallowing dysfunction in patients with NMD should be performed by experienced speech therapists in an interdisciplinary setting with regard to the fatiguability of the orophyryngeal muscles. Therapy should focus on adaptive procedures and safe, adapted nourishment.