A DYSPHAGIA CASE OF AMYOTROPHIC LATERAL SCLEROSIS WITH TRAUMATIC BRAIN INJURY

SATO Shinsuke, MIZUMA Masazumi, KAWATE Nobuyuki, YODA Mitsumasa, KITAGAWA Hironao, TOYOSHIMA Osamu, HATANO Aya, YOSHIDA Mizuho, MATSUMIYA Hidehiko, KII Yoshitaka, WATANABE Hideyasu, OKUYAMA Toru

doi:10.14930/jsma1939.63.501

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Other Title

筋萎縮性側索硬化症に頭部外傷を合併した摂食・嚥下障害患者の1例
症例報告筋萎縮性側索硬化症に頭部外傷を合併した摂食・嚥下障害患者の1例
ショウレイホウコクキンイシュクセイソクサクコウカショウニトウブガイショウオガッペイシタセッショク・エンカショウガイカンジャノ 1レイ

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Patient: 74-year-old. Male. A patient of amyotrophic lateral sclerosis (ALS) underwent brain surgery due to traumatic brain injury. The patient atc meals after undergoing the operation, but complications with pneumonia resulted in feeding with a nasal tube. The patient suffered ftom dementia in addition to weakness of the proximal limb muscles. Videof luoroscopic examination of swallowing showed food remained in the pharynx and food had gone into the larynx. However, if it was a small amount, it was possible for him to eat from the mouth. There was no desire to eat meal from the mouth at all though it was able to eat food for oneself for the hospitalization period. Therefore, we did percutaneous endoscopic gastrostomy (PEG) to him. His feeding desire improved after his discharge from the hospital, and the intake for oneself became possible partially. However, the intake for oneself became difficult again as his upper extremity function decreased. Afterwards, he died for pneumonia. In this case, the bulbar palsy caused by ALS was a comparatively light symptom. However, because he had had the decrease in the feeding desire, it was difficult for us to forecast the prognosis concerning his swallowing difficulty. In progressive diseases of the nervous system such as ALS, when some disabilities in addition to the swallowing difficulty overlapped, the necessity for doing gastrostomy at the early stage was suggested.

Journal

Journal of The Showa Medical Association

Journal of The Showa Medical Association 63 (5), 501-506, 2003

The Showa University Society

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