#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

SPEECH-LANGUAGE PATHOLOGY CARE OF PATIENTS WITH MYASTHENIA GRAVIS


Authors: Hrnčiarová Bianka 1;  Frajková Žofia 2
Published in the journal: Listy klinické logopedie 2021; 5(2): 50-55
Category: Miscellaneous

Summary

Myasthenia gravis is an autoimmune disease caused by the disruption of neuromuscular transmission, due to the production of antibodies against acetylcholine receptors located at the neuromuscular junction. The symptomatology of the disease is variable, mostly progressive, but not irreversible. With proper patient management, it is possible to achieve remission in most patients and to reduce the risk of complications such as malnutrition, dehydration and aspiration with aspiration pneumonia. Dominant bulbar symptoms include dysarthria, dysphonia and dysphagia. An important part is speech-language intervention. The most prominent symptoms in speech are fatigue of the orofacial muscles, hypernasality, and decreased volume of speech. In the oral phase, bolus formation and transport and nasal regurgitation are impaired. There is a high risk of silent aspiration in the pharyngeal phase. This fact emphasises the need for the instrumental diagnosis of swallowing deficits. Speech-language therapy for myasthenia gravis aims to alleviate muscle fatigue through compensatory strategies and the modification of solid and liquid consistencies. Timely provision of healthcare and modification of therapeutic strategies according to current speech and swallowing deficits are essential. This may help to improve treatment outcomes and the quality of life of a patient with myasthenia gravis.

Keywords:

myasthenia gravis – dysphonia – flaccid dysarthria – oropharyngeal dysphagia


Zdroje
  1. FRAJKOVA, Z., KRIZEKOVA, A., MISSIKOVA, V., TEDLA, M., 2020. Translation, Cross-Cultural Validation of the Voice Handicap Index (VHI-30) in Slovak Language. Journal of Voice [online]. Published online: 10. 5. 2020 [cit. 20. 10. 2021]. DOI: 10.1016/j. jvoice.2020.04.003.
  2. BLISSITT, P. A., FOWLER, S. B., HERRINGTON, J. B., KOOPMAN, W. J., RICCI, M., 2013. Care of the Patient with Myasthenia Gravis: AANN Clinical Practice Guideline Series. [online]. Chicago: Myasthenia Gravis Foundation of America, Inc., 2013, 32 s. [cit. 20. 10. 2021]. Dostupné z: http://myasthenia.org/LinkClick.aspx?fileticket=I2Imja5gU4s%3D&tabid=101
  3. CIAFALONI, E., 2019. Myasthenia gravis and congenital myasthenic syndromes. Continuum: Lifelong Learning in Neurology [online]. 25(6), s. 1767-1784 [cit. 19. 9. 2021]. DOI: 10.1212/CON.0000000000000800.
  4. CICHERO, J. A. Y.; MURDOCH, B. E. (ed.), 2006. Dysphagia: foundation, theory and practice [online]. John Wiley & Sons, 582 s. [cit. 8.11. 2021]. ISBN 978-0-470-02917-6. Dostupné z: https://www.wiley.com/en-sr/Dysphagia:+Foundation,+Theory+and+Practice-p-9780470029176
  5. CLAVÉ, P., et al., 2006. The effect of bolus viscosity on swallowing function in neurogenic dysphagia. Alimentary pharmacology & therapeutics [online]. 24(9), s. 1385-1394. [cit. 8.11. 2021]. Dostupné z: https://pubmed.ncbi.nlm.nih.gov/17059520/
  6. CONTI-FINE, B. M., MILANI, M., KAMINSKI, H. J., 2006. Myasthenia gravis: past, present, and future. The Journal of clinical investigation [online]. 116(11), s. 2843-2854 [cit. 17. 9. 2021]. Dostupné z: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1626141/
  7. COLTON–HUDSON, A., KOOPMAN, W. J., MOOSA, T., SMITH, D., BACH, D., NICOLLE, M., 2002. A prospective assessment of the characteristics of dysphagia in myasthenia gravis. Dysphagia [online]. 17(2), s. 147-151 [cit. 23. 9. 2021]. Dostupné z: https://pubmed.ncbi.nlm.nih.gov/11956840/
  8. CHANDRA, A., PANT, B., 2019. Hypophonia as only presenting symptom in myasthenia gravis–a diagnostic dilemma in poor countries: A case report. Journal of medical case reports [online]. 13(1), s. 1-4 [cit. 20. 9. 2021]. Dostupné z: https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-019-1970-6
  9. DEJONCKERE, P. H., BRADLEY P., CLEMENTE P., CORNUT G., CREVIER-BUCHMAN L., FRIEDRICH G., VAN DE HEYNING P., REMACLE M., WOISARD V., 2001. A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques. European Archives of Oto-rhino-laryngology [online]. 258(2), s. 77-82 [cit. 16. 9. 2021] Dostupné z: https://pubmed.ncbi.nlm.nih.gov/11307610/
  10. FARRUGIA, M.E., GOODFELLOW, J. A., 2020. A practical approach to managing patients with Myasthenia Gravis—Opinions and a review of the literature. Frontiers in Neurology [online]. 11, s. 604 [cit. 23. 9. 2021]. Dostupné z: https://pubmed.ncbi.nlm.nih.gov/32733360/
  11. FREGONEZI, G. A., RESQUETI, V. R., GUELL, R., PRADAS, J., CASAN, P., 2005. Effects of 8-week, interval-based inspiratory muscle training and breathing retraining in patients with generalized myasthenia gravis. Chest [online]. 128(3), s. 1524 [cit. 19. 10. 2021]. Dostupné z: https://pubmed.ncbi.nlm.nih.gov/16162753/
  12. GILHUS, N. E., VERSCHUUREN, J. J., 2015. Myasthenia gravis: subgroup classification and therapeutic strategies. The Lancet Neurology [online]. 14(10), 1023-1036 [cit. 15. 9. 2021]. DOI: 10.1016/S1474-4422(15)00145-3.
  13. HIGO, R., NITO, T., TAYAMA, N., 2005. Videofluoroscopic assessment of swallowing function in patients with myasthenia gravis. Journal of the neurological sciences [online]. 231(1-2), s. 45-48 [cit. 29. 9. 2021]. DOI: 10.1016/j.jns.2004.12.007.
  14. HIRANO, M., MCCORMICK, K. R., 1986. Clinical examination of voice by Minoru Hirano. The Journal of the Acoustical Society of America [online]. 80, s. 1273 [cit. 20. 10. 2021]. Dostupné z: https://asa.scitation.org/doi/10.1121/1.393788
  15. HOFFMANN, S., RAMM, J., GRITTNER, U., KOHLER, S., SIEDLER, J., MEISEL, A., 2016. Fatigue in myasthenia gravis: risk factors and impact on quality of life. Brain and behavior [online]. 6(10), e00538 [cit. 19. 9. 2021]. Dostupné z: https://onlinelibrary.wiley.com/ doi/full/10.1002/brb3.538
  16. HORÁKOVÁ, M., VOHÁŇKA, S., 2017. Škály a dotazníky používané u myastenia gravis. Neurologie pro praxi [online]. 18(5), s. 301-304 [cit. 20. 10. 2021] Dostupné z: https://www.neurologiepropraxi.cz/pdfs/neu/2017/05/03.pdf
  17. HUANG, M. H., KING, K. L., CHIEN, K. Y., 1988. Esophageal manometric studies in patients with myasthenia gravis. The Journal of thoracic and cardiovascular surgery [online], 95(2), s. 281-285 [cit. 12. 9. 2021] Dostupné z: https://pubmed.ncbi.nlm.nih.gov/3339894/
  18. IM, S., SUNTRUP- KRUEGER, S., COLBOW, S., SAUER, S., CLAUS, I., MEUTH, S. G.,DZIEWAS, R., WARNECKE, T., 2018. Reliability and main findings of the flexible endoscopic evaluation of swallowing-Tensilon test in patients with myasthenia gravis and dysphagia. European journal of neurology [online]. 25(10), s. 1235-1242 [cit. 19. 10. 2021]. Dostupné z: https://onlinelibrary.wiley.com/ doi/abs/10.1111/ene.13688
  19. JIANU, C., JIANU, S., BARSAN, C., 2019. Clinical Presentation of Myasthenia Gravis. Thymus [online]. IntechOpen [cit. 29. 9. 2021]. Dostupné z: https://www.intechopen.com/chapters/67324
  20. JUAN, H.-C., TOU, I., LO, S. CH., WU, I. H., 2010. Efficacy of postural techniques assessed by videofluoroscopy for myasthenia gravis with dysphagia as the presenting symptom: a case report. Journal of Medical Case Reports [online]. 4(1), s. 1-4 [cit. 19. 9. 2021]. Dostupné z: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3009659/
  21. KIM, S. J., PARK, G. Y., CHOI, Y., SOHN, D. G., KANG, S. R., IM, S., 2017. Bulbar myasthenia gravis superimposed in a medullary infarction diagnosed by a fiberoptic endoscopic evaluation of swallowing with simultaneous tensilon application. Annals of rehabilitation medicine [online]. 41(6), s. 1082- 1087 [cit. 29. 9. 2021]. Dostupné z: https://www.researchgate.net/publication/322383222_Bulbar_ Myasthenia_Gravis_Superimposed_in_a_Medullary_Infarction_Diagnosed_by_a_Fiberoptic_Endoscopic_Evaluation_of_ Swallowing_With_Simultaneous_Tensilon_Application
  22. KONSTANTOPOULOS, K., CHRISTOU, Y. P., VOGAZIANOS, P., PAPANICOLAOU, E. Z., KLEOPA, K. A., 2017. A quantitative method for the assessment of dysarthrophonia in myasthenia gravis. Journal of the neurological sciences [online]. 377, s. 42-46 [cit. 29. 9. 2021]. Dostupné z: https://www.academia.edu/36139300/A_quantitative_method_for_the_assessment_of_dysarthrophonia_in_ myasthenia_gravis
  23. KOŠŤÁLOVÁ, M. , MRAČKOVÁ, M., MAREČEK, R., BERÁNKOVÁ, D., ELIÁŠOVÁ, I., JANOUŠOVÁ, E., ROUBÍČKOVÁ, J., BEDNAŘÍK, J., REKTOROVÁ, I., 2013. Test 3F Dysartrický profil–normativní hodnoty řeči v češtině. Česká a Slovenská Neurologie a Neurochirurgie [online]. 76/109(5) [cit. 20. 10. 2021]. Dostupné z: https://www.csnn.eu/casopisy/ceska-slovenska-neurologie/2013-5/ test-3f-dysartricky-profil-normativni-hodnoty-reci-v-cestine-41400
  24. KOOPMAN, W. J., WIEBE, S., COLTON- HUDSON, A., MOOSA, T., SMITH, D., BACH, D., NICOLLE, M. W., 2004. Prediction of aspiration in myasthenia gravis. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine [online]. 29(2), s. 256-260 [cit. 29. 9. 2021]. Dostupné z: https://www.researchgate.net/ publication/8893369_Prediction_of_aspiration_in_myasthenia_gravis
  25. MAO, V. H., ABAZA, M., SPIEGEL, J. R., MANDEL, S., HAWKSHAW, M., HEUER, R. J., SATALOFF, R. T., 2001. Laryngeal myasthenia gravis: report of 40 cases. Journal of Voice [online]. 15(1), s. 122-130 [cit. 29. 9. 2021]. Dostupné z: https://pubmed.ncbi.nlm.nih.gov/12269627/
  26. MONTERO-ODASSO, M., 2006. Dysphonia as First Symptom of Late-Onset Myasthenia Gravis. Journal of general internal medicine [online]. 21(6), C4-C6 [cit. 18. 9. 2021]. Dostupné z: https://www.researchgate.net/ publication/6975502_Dysphonia_as_First_Symptom_of_Late-Onset_Myasthenia_Gravis
  27. MYASTHENIA GRAVIS FOUNDATION OF AMERICA, 2020. Effects of Myasthenia Gravis on Voice, Speech, and Swallowing. Myasthenia.org [online]. Dostupné z: https://myasthenia.org/What-is-MG/MG-Materials-Webinars/Brochures-Learn-More-About-MG
  28. NEMR, N. K., SIMOES- ZENARI, M., FERREIRA, T. S., FERNANDES, H. R., MANSUR, L., 2013. Dysphonia as the primary complaint in a case of myasthenia gravis: diagnosis and speech therapy. Codas [online]. 25(3), s. 297-300 [cit. 29. 9. 2021]. Dostupné z: https://www.researchgate.net/publication/259652567_Dysphonia_as_the_primary_complaint_in_a_case_of_myasthenia_gravis_ diagnosis_and_speech_therapy
  29. PONGPIPATPAIBOON, K. et al., 2018. Clinical evaluation of dysphagia. In: Dysphagia Evaluation and Treatment. Springer, Singapore [online]. S 35-98. [cit. 8. 11. 2021]. Dostupné z: https://link.springer.com/chapter/10.1007/978-981-10-5032-9_5
  30. ROUBÍČKOVÁ, J., HEDÁNEK, J. et al., 2011. Test 3F. Dysartrický profil. 3. vyd. Praha: Galén, ISBN 9788072627141.
  31. SHRUBSOLE, K. DAVIES, CH. WILLIAMS, K. L., 2021. Do people with Myasthenia Gravis need speech-language pathology services? A national survey of consumers’ experiences and perspectives. International Journal of Speech-Language Pathology [online]. S. 1-12 [cit. 27. 9. 2021]. Dostupné z: https://www.tandfonline.com/doi/abs/10.1080/17549507.2021.1961862?journalCode=iasl20
  32. ŠPALEK, P., 2008. Myasténia gravis v ambulancii praktického lekára. Via pract [online]. 5(6), s. 256-261 [cit. 17. 9. 2021]. Dostupné z: https://www.solen.sk/storage/file/article/a442a760271d1412a91ff0d83e10f0e4.pdf
  33. ŠPALEK, P., 2009. Myasténia gravis. Cesk Slov Neurol N [online]. 71/104(1), s. 7-24 [cit. 21. 10. 2021]. Dostupné z: https://www.csnn.eu/ casopisy/ceska-slovenska-neurologie/2008-1-1/myastenia-gravis-37483
  34. ŠVEC, J., LEJSKA, M., FROSTOVÁ, J., ZÁBRODSKÝ, M., DRŠATA, J., KRÁL, P., 2009. Česká verze dotazníku Voice Handicap Index pro kvantitativní hodnocení hlasových potíží vnímaných pacientem. Otorinolaringologie a foniatrie [online]. 3, s. 132-139 [cit. 21. 10. 2021]. Dostupné z: https://www.prolekare.cz/casopisy/otorinolaryngologie-foniatrie/2009-3/ceska-verze-dotazniku-voice-handicap-index-pro -kvantitativni-hodnoceni-hlasovych-potizi-vnimanych-pacientem-7605
  35. TROUTH, A. J., DABI, A., SOLIEMAN, N., KURUKUMBI, M., KALYANAM, J., 2012. Myasthenia gravis: a review. Autoimmune diseases [online]. 2012:874680 [cit. 29. 9. 2021]. Dostupné z: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501798/
  36. WARNECKE, T. et al., 2017. Aspiration and dysphagia screening in acute stroke–the Gugging Swallowing Screen revisited. European journal of neurology [online]. 24(4), s. 594-601. [cit. 8.11. 2021]. Dostupné z: https://pubmed.ncbi.nlm.nih.gov/28322006/
  37. WARNECKE, T., IM, S., LABEIT, B., ZWOLINSKAYA, O., SUNTRUP- KRUGER, S., OELENBERG, S., AHRING, S., SCHILLING, M., MEUTH, S., MELZER, N., WEINDL, H., RUCK, T., DZIEWAS, R., 2021 Detecting myasthenia gravis as a cause of unclear dysphagia with an endoscopic tensilon test. Therapeutic Advances in Neurological Disorders [online]. 14 [cit. 27. 9. 2021]. Dostupné z: https://journals.sagepub.com/doi/full/10.1177/17562864211035544
  38. WENDELL, L. C., LEVINE, J. M., 2011. Myasthenic crisis. The Neurohospitalist [online]. 1(1), s. 16-22 [cit. 17. 9. 2021]. Dostupné z: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3726100/
Štítky
Clinical speech therapy General practitioner for children and adolescents

Článok vyšiel v časopise

Clinical speech therapy (Listy klinické logopedie)

Číslo 2

2021 Číslo 2
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#