The
cause of all my coughing and choking is complicated and very
annoying.....partly allergy and asthma symptoms and changes in
swallowing caused by m.s.
Articles
Cause of death in patients attending multiple sclerosis clinics
- A. D. Sadovnick, PhD,
- K. Eisen, RN,
- G. C. Ebers, MD and
- D. W. Paty, MD
Abstract
Between 1972 and 1988, 145 deaths occurred
among 3,126 patients attending the Multiple Sclerosis (MS) Clinics in
Vancouver,
British Columbia (N = 1,583), and London, Ontario
(N = 1,543).
We could determine the exact cause of death in 82.1% of
cases
(119 of 145). Of the 119 patients for whom the
cause of death was known, 56 deaths (47.1%) were directly attributed to
complications
of MS.
Of the remaining 63 deaths, 18 (28.6%) were
suicides, 19 (30.2%) were due to malignancy*, 13 (20.6%) to an acute
myocardial
infarction, seven (11.1%) to stroke, and the
remainder (9.5%) to miscellaneous causes,
of which two may have been
suicides (add the 2 possible suicides and you have 32% suicides).
The proportion of suicides among MS deaths was 7.5
times that for the age-matched general population, and the proportion of
MS deaths from malignancy was 0.67 times that for
the age-matched general population.
The proportion of deaths due to
malignancy
and stroke was the same for the MS patients and the
age-matched general population.
- © 1991 by Edgell Communications, Inc.
*the state or presence of a malignant tumor; cancer.
www.neurology.org/content/41/8/1193.short
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Dysphagia in multiple sclerosis
Abstract
Objectives:
(1) To determine the prevalence of swallowing problems in MS patients
and its relation to the overall disability.
(2) To define the most
frequent symptoms suggestive of dysphagia.
(3) To describe the
abnormalities on manofluoroscopy (MFS).
Methods: Three hundred
and eight consecutive MS patients were asked whether they ever had
swallowing problems. If so the questionnaire of the Johns Hopkins
Swallowing Centre was applied to qualify the dysphagia.
A MFS was
performed in 30 patients with dysphagia covering the entire spectrum of
MS. Overall disability was assessed using the Expanded Disability Status
Scale (EDSS).
Results: Seventy-three of our 309 patients had
permanent dysphagia (24%). Another 5% had a history of transitory
swallowing problems only. Permanent dysphagia started to be a problem in
mildly impaired patients (EDSS 2–3).
Prevalence increased together with
rising disability to reach 65% in the most severely disabled subjects
(EDSS 8–9).
Two alarming symptoms of patients with swallowing problems,
coughing or choking during the meal and a history of pneumonia were
present in 59%, respectively, 12% of these patients. MFS showed
deficiency of the oral phase in all patients, while only the patients
with an EDSS higher than 7.5 showed abnormalities of the pharyngeal
phase.
Conclusions: Permanent dysphagia may already develop in
mildly impaired MS patients but becomes a rather frequent finding in MS
patients with moderate or severe disability.
MFS is a sensitive and
useful ancillary examination. Important qualitative changes of the
pharyngeal phase on MFS are seen in patients with an EDSS higher than
7.5.
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Speech and Swallowing Symptoms Associated with Parkinson’s Disease and Multiple Sclerosis: A Survey
Hartelius L. · Svensson P.
Department of Logopedics and Phoniatrics, University of Göteborg, Sweden
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Abstract
A survey of approximately 460 patients with Parkinson’s
disease (PD) or multiple sclerosis (MS) shows that
speech and swallowing
difficulties are very frequent within these groups.
Seventy percent of
the PD patients and
44% of the MS patients had experienced impairment of
speech and voice after the onset of their disease.
Forty-one percent of
the PD patients and
33% of the MS patients indicated impairment of
chewing and swallowing abilities.
The speech disorder was regarded as
one of their greatest problems by 29% of the PD patients and by 16% of
the MS patients.
Only a small number of patients, 3% of the PD and 2% of
the MS group, had received any speech therapy.
© 1994 S. Karger AG, Basel
http://www.karger.com/Article/Abstract/266286