Abstract
This is a report of a questionnaire sent to the neurologists in 36 national hospitals about the management of dysphagia for patients with amyotrophic lateral sclerosis (ALS).
At 21 out of 36 hospitals (58%) management of dysphagia was started when symptoms of dysphagia appeared. When there was inadequate oral intake tube feeding was introduced as a supplemental route in 27 of 36 (76%) hospitals. But in 56% of them percutaneous endoscopic gastrostomy (PEG) was recommended when oral nutrition failed. In 15 (42%) hospitals frequency in complications of PEG placement was more than 5%. The risks of PEG included respiratory failure due to procedural sedation or pain, peritonitis, failure to place PEG tube, and localized infection. Surgical intervention to prevent aspiration, such as laryngeal diversion, was done in 15 (42%) hospitals. Only 5 (14%) of hospitals have swallowing programs.
