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

A new case of sub-occipital Pott's disease is reported: a 26 year old, coloured male patient from Senegal was admitted for: cervical pain of 6 month duration, neck stiffness, dysphagia, left XII paralysis and left hemiparesis. The radiological study found an anterior atlanto-axial subluxation, basilar impression, and increased thickness of the retropharyngeal soft tissue, lysis of the left occipital condyle and the left lateral mass. CT scan study revealed a retropharyngeal mass and an epidural contrast-enhanced lesion at the C2 C3 C4 levels. Chest-X ray showed one tuberculous lesion at the right apex. The research of Acid Fast Bacilli in gastric secretion samples and the results of the retropharyngeal mass puncture were positive. An antituberculous trichemotherapy was started. After early reduction by skull tongs traction, an occipito-cervical arthrodesis by Roy Camille plates was performed, followed by the wearing of a minerva plaster jacket and then a plastic collar. Each one for a 5 month period. One year later, there remained only a left XII paralysis, but the bony reconstruction was not yet obvious on tomography. A survey of the literature of 70 cases of sub-occipital Pott's disease has pointed out these findings: cervical pain (98%), neck stiffness (82%), Atlantoaxial subluxation (68%), thickened prevertebral soft tissue shadow (77%), lateral mass lysis (48%) other tuberculous focus (29%). The main therapeutic trends are: early and long-lasting antituberculous poly-chemotherapy, early reduction of subluxations, prolonged contention for slight osteolytic lesions and for major: lytic lesions, a posterior surgical procedure either by bone graft combined with wires or preferably fusion by means of occipito-cervical plates. The removal of abscess is discussed.
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PMID:[Suboccipital Pott's disease]. 344 87

An autosomal dominant presenile dementia affecting 39 individuals in a seven-generation, 383-member pedigree has been studied at Indiana University. In the affected members of this family, clinical symptoms occurred early in life, with an average age at onset of 48.8 years. The presenting clinical features include disequilibrium, neck stiffness, dysphagia, and memory loss. As the disease progresses, further cognitive decline, superior-gaze palsy, and dystaxia also are observed. The average duration from onset of symptoms to death is approximately 10 years. Neuropathologic studies of nine affected individuals showed neuronal loss in several areas of the CNS, as well as argentophilic tau-immunopositive inclusions in neurons and in oligodendroglia. A limited genomic screen by use of DNA samples from 28 family members localized the gene for this disorder to a 3-cM region on chromosome 17, between the markers THRA1 and D17S791. The gene for tau also was analyzed, through samples from the family.
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PMID:Familial multiple-system tauopathy with presenile dementia is localized to chromosome 17. 934 89

We describe two patients with generalized tetanus, a 60-year-old man and a 76-year-old woman, presenting with dysphagia as an initial symptom of the disease. Eighty percent of patients with generalized tetanus manifest dysphagia on admission to a hospital. However, dysphagia is rare as an initial symptom. Both our patients had dysphagia as their initial symptom, followed by neck stiffness and trismus. We made a diagnosis of generalized tetanus based on these neurological findings in the absence of an apparent episode of trauma. After the administration of tetanus immunoglobulin on admission, they recovered without exhibiting generalized convulsion, autonomic storm, or any other serious complications. The vaccination of tetanus toxoid cannot maintain sufficient antibody titers more than ten years. Therefore, elderly people are considered susceptible to tetanus. We suggest that tetanus should be considered in the differential diagnosis of dysphagia particularly in elderly patients. We also suggest that treatment of tetanus should be initiated immediately, because tetanus still has a high mortality rate at present.
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PMID:[Two cases of generalized tetanus presenting with dysphagia as an initial symptom]. 1472 38

The case of a 34-year-old otherwise healthy woman with retropharyngeal abscess due to a fishbone injury and presenting with neck stiffness and aphagia without visualization of a pharyngeal mucosal lesion is reported. The case illustrates that sore throat with symptoms out of proportion to oropharyngeal findings should prompt a search for pathologies other than simple pharyngotonsillitis. Other typical symptoms of a retropharyngeal abscess are high fever, dysphagia, hot potato voice and, less commonly, dyspnea and sepsis. Retropharyngeal abscess in adults occurs most often as a complication of a spread of infection from a pharyngeal focus, a foreign body injury, an iatrogenic trauma due to tracheal intubation or endoscopy, and blunt or perforating neck trauma. Contrary to children, a retropharyngeal abscess in adults without loco-regional infection or preceding trauma is very rare. This case illustrates how important imaging investigations (CT-scan) are in order to locate foreign bodies and to decide on surgical management. Aetiology, presenting signs, symptoms, methods of diagnosis, treatment and complications of a retropharyngeal abscess are briefly discussed.
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PMID:[Uncommon position of a retropharyngeal impacted fishbone]. 1561 6

For five years, a 56-year-old woman had undergone "Shiatsu" (a technique that uses fingers and the palm of the hand to apply pressure to particular sections of the body's surface to correct neck stiffness and body imbalances in order to maintain and promote health). She suddenly developed neck pain, dizziness, dysphagia, and speech and gait disturbances during treatment. A neurological examination detected bradylalia and truncal and mild bilateral limb ataxia of the cerebellar type. Diffusion-weighted brain MRI showed multiple hyperintense signal lesions at the bilateral cerebellar hemisphere in the posterior inferior cerebellar artery territory. Three-dimensional computed tomographic angiography (3D-CTA) revealed irregular stenosis of the intracranial right vertebral artery (string sign). Dissection of the intracranial portion of the vertebral artery owing to trauma is rare. Physicians need to be aware of patients who have acute dissecting infarction after long periods of repeated trivial pressure such as "Shiatsu". 3D-CTA is a very useful diagnostic procedure for arterial dissection.
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PMID:[Bilateral cerebellar infarction caused by intracranial dissection of the vertebral artery after long periods of "Shiatsu"]. 1731 59

For five years, a 56-year-old woman had undergone "Shiatsu" (a technique that uses fingers and the palm of the hand to apply pressure to particular sections of the body's surface to correct neck stiffness and body imbalances in order to maintain and promote health). She suddenly developed neck pain, dizziness, dysphagia, and speech and gait disturbances during treatment. A neurological examination detected bradylalia and truncal and mild bilateral limb ataxia of the cerebellar type. Diffusion-weighted brain MRI showed multiple hyperintense signal lesions at the bilateral cerebellar hemisphere in the posterior inferior cerebellar artery territory. Three-dimensional computed tomographic angiography (3D-CTA) revealed irregular stenosis of the intracranial right vertebral artery (string sign). Dissection of the intracranial portion of the vertebral artery owing to trauma is rare. Physicians need to be aware of patients who have acute dissecting infarction after long periods of repeated trivial pressure such as "Shiatsu". 3D-CTA is a very useful diagnostic procedure for arterial dissection.
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PMID:[Bilateral cerebellar infarction caused by intracranial dissection of the vertebral artery after long periods of "Shiatsu"]. 1738 Jul 82

A 25-year-old patient with spinal muscular atrophy (SMA) type II was referred due to swallowing problems related to prolonged nonoral feeding. Restriction of jaw movement, neck stiffness, absence of oral food intake, and weakness of the oropharyngeal and laryngeal muscles were considered to be the main factors contributing to the deterioration of his swallowing function. Treatment comprised exercises to improve flexibility of the neck and temporomandibular joint, tactile oral stimulation, passive and active oropharyngolaryngeal exercises, and supraglottic swallowing maneuvers. Treatment was performed for 30 min per day, three times a week, for 7 months. On initial videofluoroscopic examination, the patient was unable to safely tolerate any per-oral nutrition. After 7 months of treatment, the patient's swallowing function had improved to the extent that he was able to resume oral intake of food under supervision, and aspiration was no longer evident. These findings suggest that noninvasive treatment is a possible strategy for enhancing the swallowing function of a patient with SMA type II presenting with swallowing difficulties related to prolonged nonoral feeding.
Dysphagia 2010 Sep
PMID:Noninvasive treatment strategy for swallowing problems related to prolonged nonoral feeding in spinal muscular atrophy type II. 2008 5

Ganglioneuromas rarely occur in the retropharynx with only three cases reported in the current literature. The most common symptom associated with retropharyngeal ganglioneuromas is dysphagia. We report a retropharyngeal ganglioneuroma with an unusual clinical presentation of neck stiffness and pain. A 42-year-old woman presented with incapacitating neck pain, neck stiffness, right upper extremity weakness, as well as dysphagia. Neurological workup was normal. Imaging revealed a hyperdense, ill-defined, diffuse right retropharyngeal mass suggestive of a possible nerve sheath tumor with no communication with the cervical spine. Surgical removal was uneventful and associated with a postoperative Horner's syndrome. In follow-up, dysphagia and neck symptoms improved. Retropharyngeal ganglioneuromas can occur in a wide age range of patients. Surgical excision via a cervical approach offers definitive therapy but may be associated with an iatrogenic Horner's syndrome for which the patients should be counseled prior to operative intervention. Neck pain is an atypical symptom that needs to be worked up to rule out a communication with the spinal column prior to surgical removal. Patients must be counseled that atypical symptoms may not completely resolve with surgical treatment.
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PMID:Retropharyngeal ganglioneuroma presenting with neck stiffness: report of a case and review of literature. 2135 3

We present the case of a 56-year-old male patient with a history of glottic carcinoma treated with concurrent chemotherapy and radiotherapy in complete remission, who went to hospital with severe neck pain, upper right limb weakness and dysphagia. Physical examination showed neck stiffness as well. Spondylitis at C6-C7 spinal level with extradural abscess formation was diagnosed by MRI. Barium radiography revealed an esophageal ulcer with a posterior sinus path. Conservative treatment was given with percutaneous gastrostomy and antibiotics. The patient's symptoms improved and the fistula and the abscess had disappeared in the later MRI control studies.
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PMID:[Spinal-esophageal fistula in a patient treated with concurrent chemotherapy and radiotherapy]. 2142 68

A 74-year-old woman was admitted to our hospital due to severe nuchal pain and occipitalgia. Neurological examination found neck stiffness but no throat pain or dysphagia. Blood examination showed slight elevation of white blood cell count, but C-reactive protein level was normal. Cerebrospinal fluid examination found no abnormalities. Computed tomography (CT) and magnetic resonance (MR) imaging demonstrated no abnormalities in the brain. Cervical CT showed a small calcification in front of the C1 body. Cervical T(2)-weighted MR imaging showed a high intensity area in front of the upper cervical vertebral body from C1 to C4, suggesting inflammation of the longus colli muscles. We diagnosed acute calcific prevertebral tendonitis. She was administered nonsteroidal anti-inflammatory drugs. Her symptoms gradually improved and she was discharged without neurological deficit 8 days after admission. It is important to be aware of the possibility of this rare disease in a patient with severe occipitalgia but no sign of intracerebral lesion.
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PMID:Acute calcific prevertebral tendonitis mimicking tension-type headache. 2300 73


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