MND-DYSPHAGIA

SUMMARY

1. Symptoms of dysphagia in MND: jaw weakness, fatigue, drooling, choking, slow eating.

MANAGEMENT
2. Refer to speech therapist for swallowing assessment.
3. VFSS/MBS to investigate.

4. Early management: modification of food bolus and fluid consistency, coaching and training by the speech therapist guided by the MBS examination.
5. If dysphagia progresses & conservative management does not maintain safe caloric intake: proceed to PEG insertion.
6. This should be done before VC falls below 50% of age-predicted values.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].