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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case is described of a lady who developed dysphagia and dysphonia misdiagnosed first as hysteria, then as myasthenia gravis, one year after a Cloward's operation for cervical disc disease. After a bout of coughing the bony dowel was expelled and the correct diagnosis was made.
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PMID:Osteoptysis: a complication of cervical spine surgery. 147 29

Thirty consecutive patients with globus sensation who were referred to a psychosomatic clinic prospectively underwent otolaryngological, videokinematographic, and manometric examinations of pharynx and esophagus to evaluate whether morphological abnormalities or motility disorders underlay their symptom. When indicated by findings, 24-hour pH-metry, scintigraphy of bolus transport, and esophagogastroscopy were performed. Seven patients were shown to have achalasia, 10 had "hypochalasia" (lower esophageal sphincter relaxation less than 75% with esophageal contraction abnormalities but no complete distal aperistalsis), and 1 had diffuse esophageal spasms; 2 patients had also hyperplastic lingual tonsils, 1 had tonsillitis, and 1 had a cervical spondylophyte. Nutcracker esophagus and nonspecific contraction abnormalities were found in 7 patients, and gastroesophageal reflux with esophagitis and a low lower esophageal sphincter resting pressure was found in 1; only 3 patients had normal esophageal motility. None had volunteered dysphagic symptoms at primary evaluation. Psychometric investigations in consenting patients showed no higher mean scores for state and trait anxiety, depression, hysteria, and hypochondriasis than in general medical outpatients. Esophageal motor disorders may, before giving rise to dysphagia, be sensed more vaguely and induce the globus sensation. However, only disappearance of the sensation after treatment allows inferring an etiological significance of such a disorder.
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PMID:High incidence of esophageal motor disorders in consecutive patients with globus sensation. 195 17

The article discusses the usefulness and technique of investigation of suspected psychogenic dysphagia by surface electromyography (sEMG) of deglutition. Thirty-two patients with suspected psychogenic dysphagia (Group 1) and 40 healthy individuals (Group 2) were involved in the study. The timing, amplitude and graphic patterns of activity of the masseter, submental, infrahyoid and trapezius muscles were examined during voluntary single water swallows ("normal"), and continuous drinking of 100 cc of water. The muscle activity in oral, pharyngeal and initial oesophageal stages of swallowing was measured, and graphic records were evaluated in relation to timing and voltage. Globus hystericus was found in only 14 patients of the Group 1 (43.75%). The main sEMG pattern of psychogenic dysphagia is a lack of any pathologic changes of timing, voltage and graphic patterns of deglutition. In 28% of cases tension of skeletal muscles not involved in deglutition was observed during single swallowing (vs. 0% in controls). Psychogenic/hysteria-conversion dysphagia has no pathologic sEMG patterns associated with deglutition. Skeletal muscle tension during deglutition, being observed in some cases has no connection with the act of swallowing itself. Surface EMG, being non-invasive and non-radiographic, can be used for screening purposes for patients with dysphagia thus avoiding expensive and time-consuming investigation.
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PMID:The electrodiagnostic examination of psychogenic swallowing disorders. 1798 52

The report presents a definition and causes of syncope in children. Syncope differs from other states with loss of consciousness by causes leading to decreased perfusion and resultant transient cerebral dysfunction with decreased muscle tone. The most common causes of syncope noted in almost 15% of children are neurocardiogenic. This group includes vasovagal, carotid sinus reflexive, situational (coughing, dysphagia, micturation and defecation disturbances) and post-exercise syncope. Another group is represented by orthostatic syncope that may be triggered by primary and secondary dis-autonomy, decreased blood volume (hemorrhage, diarrhea, Addison's disease), some medications and substances of abuse (alcohol). An important group, accounting for 2%-6% of all cases, are cardiogenic syncope, caused mainly by congenital/acquired obstructive cardiac sub- and valvar heart defects, various cardiomyopathies, some heart tumors (e.g. myxoma), exudative pericarditis, pulmonary embolus and hypertension, congenital and acquired coronary anomalies, various significant brady-tachyarrhythmias (sick sinus syndrome, supra- and ventricular tachycardias, congenital and acquired atrio-ventricular blocks). Subclavian steal syndrome as the cause of syncope is exceptional in children. Syncope does not include loss of consciousness due to neurological and metabolic (hypoglycemia) causes, hypoxia, hyperventilation with hypocapnia or CO intoxication. Differential diagnosis should also include pseudo-syncope (hysteria). Preliminary diagnostic management should include a detailed medical history, including family history, on the frequency and circumstances of syncope, sudden deaths, a physical exam with orthostatic assessment of peripheral blood pressure and standard ECG (heart rate, intraventricular and atrioventricular conduction defects, cardiac hypertrophy, arrhythmias, L-QT, changes in ST-T). Further specialist tests depend on preliminary findings.
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PMID:[Syncope in children and adolescents]. 1843 21