Choking and Dysphagia in multiple sclerosis

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.

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Cause of death in patients attending multiple sclerosis clinics

1. A. D. Sadovnick, PhD,
2. K. Eisen, RN,
3. G. C. Ebers, MD and
4. D. W. Paty, MD

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1. doi: http:/​/​dx.​doi.​org/​10.​1212/​WNL.​41.​8.​1193 Neurology August 1991 vol. 41 no. 8 1193

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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

A De PauwPress enter key for correspondence informationPress enter key to Email the author

,

E Dejaeger

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B D'hooghe

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H Carton

DOI: http://dx.doi.org/10.1016/S0303-8467(02)00053-7

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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.

Keywords:

Multiple sclerosis, Dysphagia, Prevalence, Diagnosis

http://www.clineu-journal.com/article/S0303-8467(02)00053-7/abstract?cc=y=

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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