Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirteen infants and children with proved gastroesophageal (GE) reflux had complaints that suggested a CNS disorder. Symptoms began in early infancy in ten cases, but accurate diagnosis and proper treatment were not instituted in three cases until three to five years of age. A CNS basis for their disease was suspected because they exhibited specific signs or because the importance of associated gastrointestinal (GL) and respiratory tract symptoms was not appreciated. The presenting CNS symptoms and signs included dystonia in 11, developmental retardation in ten, dysphagia in nine, seizures in six, and extreme irritability in ten. We believe that the diagnosis of symptom-causing GE reflux is being missed regularly. The effects of proper medical or surgical therapy are often dramatic, and the consequences of missed diagnosis or improper treatment are potentially lethal.
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PMID:Childhood gastroesophageal reflux. Neurologic and psychiatric syndromes mimicked. 57 80

Recurrent vomiting is common in children with severe mental retardation and leads to significant morbidity with malnutrition, anemia, and aspiration pneumonitis. Spasms of the abdominal muscles and diaphragm, uncoordinated peristalsis, and central nervous system disorders are causes of dysphagia and continuous gastroesophageal reflux. It is desirable that mentally retarded children with vomiting have a barium swallow and esophagoscopy as early as possible. Fundoplication should be performed before complications develop. Spasms with aspiration followed by apnea, in particular, are life-threatening situations. After surgery there is a definite improvement in mental and physical development.
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PMID:Gastroesophageal reflux and severe mental retardation. 392 35

Oropharyngeal dysphagia results from disruption of the integrated mechanism of swallowing. Neurogenic dysphagia is caused by central nervous system disorders or by cranial nerve involvement and it may be distinguished from muscular dysphagia such as that seen mostly in oculopharyngeal muscular dystrophy (OPMD). Based on our 20-year experience in a university hospital thoracic surgery service, we describe the results of the clinical evaluation, the laboratory testing and the surgical management of a recent subgroup of patients experiencing dysphagia from neurogenic and muscular disorders.
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PMID:Cricopharyngeal myotomy in the management of neurogenic and muscular dysphagia. 939 23

Vocal fold paralysis (VFP) is an important cause of respiratory and feeding compromise in infants. The causes of neonatal VFP are varied and include central nervous system disorders, birth-related trauma, mediastinal masses, iatrogenic injuries, and idiopathic cases. Bilateral VFP often presents with stridor or respiratory distress and can require rapid intervention to stabilize an adequate airway. Unilateral VFP presents more subtly with a weak cry, swallowing dysfunction, and less frequently respiratory distress. The etiology and type of VFP is important for management. Evaluation involves direct visualization of the vocal folds, with additional imaging and testing in select cases. Swallowing dysfunction, also known as dysphagia, is very common in infants with VFP. A clinical assessment of swallowing function is necessary in all cases of VFP, with some patients also requiring an instrumental swallow assessment. Modification of feeding techniques and enteral access for feedings may be necessary. Airway management can vary from close monitoring to noninvasive ventilation, tracheostomy, and laryngeal surgery. Long-term follow-up with otolaryngology and speech-language pathology service is necessary for all children with VFP to ensure adequate breathing, swallowing, and phonation. The short- and long-term health and quality-of-life consequences of VFP can be substantial, especially if not managed early.
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PMID:Neonatal Vocal Fold Paralysis. 3235 44