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

A 77-year-old man presented with a 4-year history of progressive dysphagia to the point that he could no longer swallow solid foods. During the past several months, he had developed dysphonia. Cervical spine x-ray films demonstrated massive anterior degenerative osteophytic spurs between C-3 and C-7. Evaluation with barium swallow and cervical computed tomography demonstrated esophageal and laryngeal compression. Resection of the anterior osteophytes resolved the dysphagia and dysphonia.
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PMID:Dysphagia and dysphonia secondary to anterior cervical osteophytes. 394 83

The spontaneous occurrnce of blepharospasm and dystonic movements in face muscles, particularly those of the perioral and mandibular regions, has been named Meige's disease. Other dystonic features as spasmodic torticollis, dysphagia, spasmodic dysphonia and segmental dystonia of the limbs may, eventually, be present in the same patient. There is very little knowledge about the pathology of this disease. Many hypotheses concerning the pathophysiology of this entity have been put forward, most of them correlating the clinical response to several drugs with known action on the neurotransmitter system of the brain. There are some evidences that it may exist a dopaminergic preponderance in the disease. In the nigro-striatal pathway, one of the retrograde loops in the feed-back control of dopamine synthesis by nigral neurons is dependent on GABA. Increasing GABA activity through GABA agonists that cross the blood-brain barrier could result in a decreased dopaminergic action in the nigro-striatal pathway and, thus, ameliorate the dystonic symptoms which might have been produced by its increased function. We have used baclofen, a GABA-agonist drug, to treat five patients with Meige's disease, in a single-blinded trial. These were four females and one male, with age ranging from 50 to 63 years. The drug was started at 20mg/day, being increased by 10mg each three days reaching a maximum dose of 70mg/day. One of the patients showed marked improvement of blepharospasm and orofacial dystonia and a second patient had a moderate improvement in the same symptoms. Another patient showed moderate improvement of limb dystonia, but had no benefit in the facial movements.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Treatment of Meige disease with a GABA receptor agonist]. 409 37

This paper reports the findings in a 32-year-old man who presented in adult life with a myasthenic syndrome characterized by dysphagia, dysphonia, fluctuating ptosis, episodic diplopia and a variable weakness of the limbs and trunk. Electromyography showed a small decremental response, increased neuromuscular jitter and blocking of some components. Histochemical and electron microscopic studies revealed changes in end-plate morphology and prominent tubular aggregations within the muscle fibres. Radiochemical investigations using di-iodinated 125I-alpha-bungarotoxin demonstrated a reduction in the number of AChR and alterations in receptor affinity which suggested an abnormality of the AChR macromolecule.
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PMID:Alterations in the number and affinity of junctional acetylcholine receptors in a myopathy with tubular aggregates. A newly recognized receptor defect. 626 5

The authors report a case of a 27 year old male patient who has exhibited external ophthalmoplegia, anisocoria, ataxia, absent deep reflexes, dysphagia, dysphonia, bilateral peripheral facial paralysis, hypopallesthesia and a mild sensory impairment of the four extremities. In addition, his cerebrospinal fluid showed albuminocytologic dissociation. The otoneurologic examination showed important findings. These symptoms began ten days after a "cold", and quickly subsided after prednisone therapy. Two months after the onset of clinical features, just a deep apendicular areflexia was detected on his neurological examination. The neurological signs and complementary laboratory findings suggest that both central and peripheral alterations are responsible for the clinical manifestations.
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PMID:[Miller Fisher syndrome: report of a case]. 647 79

We assessed the feasibility of a selective policy for operative exploration of penetrating neck wounds. Patients with bleeding, hematomas, crepitations, dysphagia, dysphonia, or impaired mental status rendering their conditions nonevaluative had prompt explorations. All other patients were observed in the hospital. Of the 77 patients in this study, 48 (62%) underwent neck exploration based on the preceding criteria; (85%) had major injuries. Of the 29 patients observed according to protocol, none required subsequent exploration for a missed lesion. Ancillary diagnostic procedures in the observed patients consisted of arteriography in four, esophageal contrast studies in five, esophagoscopy in two, and laryngoscopy in one. The average hospital stay for observation was 1.8 days. Our experience confirms the safety and cost-effectiveness of selective exploration for penetrating neck injuries. Moreover, observation does not mandate extensive ancillary testing for level II and III injuries.
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PMID:Selective management of penetrating neck injuries. A prospective study. 671 71

Eleven cases presenting a syndrome of the medulla oblongata are discussed with reference to the findings of clinical and angiographic investigation. The diagnosis of Wallenberg's syndrome is justified when the classic symptoms are apparent (Horner's syndrome, nystagmus, dysphonia and dysphagia, ataxia, ipsilateral sensory impairment of the face and contralateral elsewhere, and accompanying vegetative disturbances). If additional symptoms such as a facial or extra-ocular muscle paresis, especially hemiparesis, exist, another, more lateral or medial, syndrome of the oblongata should be considered. Angiographic findings vary considerably, ranging from a normal vertebral artery or posterior inferior cerebellar artery (PICA) to an occlusion of these arteries (in three and two of the 11 cases respectively). Modification are often seen in the anterior inferior cerebellar artery (AICA). A kind of complementary supply in the PICA-AICA region must occasionally exist. Localised processes affecting these vessels rather than diffuse multifocal vascular processes would lead to Wallenberg's syndrome. It is difficult to conclude from the clinical picture where a possible responsible vascular narrowing or obliteration may lie, even if pareses of the limb were present.
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PMID:[Clinical and angiographic findings in vascular medullary syndromes (author's transl)]. 731 26

Reports on the surgical management of the vascular ring formed by the right aortic arch with aberrant retroesophageal left subclavian artery and left ligamentum arteriosum are relatively few. The authors present a case of a thirty-three-year old woman with cough, dysphonia and stridor without dysphagia. Surgical management which was performed through a bilateral thoracotomy with transversal sternotomy, included division of the ligamentum arteriosum and of the aberrant left subclavian artery and suture of the latter. There was no need to resect the Kommerell's diverticulum, because of lack of any dysphagia despite of the well documented severe compression of the esophagus. The authors experience proved that in difficult cases the bilateral thoracotomy and transversal sternotomy is an useful approach to perform complete surgical repair of this abnormality.
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PMID:[The surgical correction of the right aortic arch with aberrant left subclavian artery and left ligamentum arteriosum--a rare case from clinical practice]. 747 58

Sarcoidosis is usually a multisystem granulomatous disease, and it sometimes affects the larynx and causes symptoms of dysphonia, dyspnea, and dysphagia. Laryngeal sarcoid has a characteristic appearance at direct or indirect laryngoscopy: the supraglottic tissues are symmetrically affected with a pale, diffusely swollen appearance somewhat like that of epiglottitis. Five cases of laryngeal sarcoid are presented. Three photographs taken at direct laryngoscopy, and one at indirect laryngoscopy, document and emphasize the typical appearance of the supraglottic tissues. The appearance of this uncommon condition is sufficiently characteristic to suggest the diagnosis, which can finally be confirmed only by biopsy.
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PMID:Laryngoscopic diagnosis of laryngeal sarcoid. 759 64

Management of thyroid tumor can be problematic in developing countries due to poor diagnostic and therapeutic facilities. This is true in Burkina Faso where there are no facilities for radioisotope scans and intraoperative biopsy is usually unfeasible due to a shortage of histologists. The purpose of this retrospective analysis of the files of 83 patients who underwent surgery of the thyroid between January 1988 and December 1993 at the National Hospital Center of Ouagadougou was to obtain information necessary to define suitable pre-, per-, and post-operative strategies for these conditions. The mean delay to consultation for the 83 patients studied was 8 years. The fact that dysphonia and/or dysphagia was present at the first examination in 68 cases and that paralysis of the recurrent laryngeal nerve was observed in 17 cases testifies to the advanced stage at which patients were seen. Cancer was confirmed in only 3 of the 41 surgical specimens that were examined (7.3%). In cases involving only one nodule with no signs of malignancy, resection of the nodule is justifiable (18.1% of cases). In other cases radical resection is indicated either by lobo-isthmectomy or subtotal thyroidectomy for diffuse or multinodular goiter (74.7% of cases) or by total thyroidectomy (7.2% of cases). The immediate postoperative period was marked by the occurrence of hemorrhage (n = 7), transient paralysis of the recurrent laryngeal nerve (n = 4), and infection of the surgical wound (n = 5). There were 2 deaths.
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PMID:[Problems after thyroid gland surgery in Burkina Faso, 83 cases]. 763 10

A 57-year-old male with clival chordoma developed severe hoarseness, dysphagia, and dysphonia 1 month after a second removal of the tumor. Magnetic resonance imaging demonstrated a mass 10 cm in diameter in the region of the middle clivus enhanced inhomogeneously by gadolinium-diethylenetriaminepentaacetic acid, and a defect in the skull base. There was evidence of compression of the anterior surface of the pons. He received proton irradiation employing a pair of parallel opposed lateral proton beams. The dose aimed at the tumor mass was 75.5 Gy, to the pharyngeal wall less than 38 Gy, and to the anterior portion of the pons less than 30 Gy. Time dose and fractionation factor was calculated at 148. Thirty-one months following treatment, he was free of clinical neurological sequelae. Proton therapy should be considered in treatment planning following initial surgical removal or for inoperable clivus chordoma.
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PMID:Proton radiation therapy for clivus chordoma--case report. 768 25


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