Assessment of Dysphagia in Patients with Multiple Sclerosis

Abstract

Objectives: This study was conducted to estimate the prevalence of swallowing impairment in Relapsing-remitting multiple sclerosis (RRMS) cases and determine if there is any correlation between disability status and the severity of swallowing impairment to take the results into consideration while drawing the intervention plan.Patients and Methods: The study included 40 patients diagnosed with RRMS, and they were subjected to history taking, neurological examination, and Fiberoptic Endoscopic Evaluation of Swallowing (FEES), The Yale pharyngeal residue severity rating scale was used.Results: FEES revealed that 50 % of RRMS patients had no residue, 35% had mild residue and 15% had moderate residue. Additionally, 15% of the patients had choked with penetration, but there was no aspiration or nasal regurgitation. There was no statistically significant difference between the three groups of FEES findings regarding the expanded disability status scale (EDSS). The incidence of swallowing impairment increased with disease duration > 1 year, EDSS > 3, and in patients with more than 2 relapses.Conclusion: About half of the RRMS patients have pharyngeal residue post-swallow with variable degrees. Disease duration >1 year, a number of relapses >2 relapses, and EDSS >3 are significant risk factors for choking in MS patients. Keywords: Multiple Sclerosis, swallowing, swallowing impairment, fiber optic endoscopic evaluation of swallowing, EDSS.