2015 Volume 29 Issue 4 Pages 350-356
Dysphagia symptoms of ALS patients are diverse, such as difficulty in swallowing and choking. It isknown that the risks of aspiration and suffocation increase with disease progression, but it has not been clarified when the risks increase. To reduce these risks, evaluation of the swallowing function before the aggravation of dysphagia, avoidance of aspiration and suffocation risks, and appropriate nutritional management are necessary. This study was performed to clarify the association between the ALS evaluation scales and the swallowing function. The subjects were 57 ALS patients who underwent videofluorography of swallowing (38 males and 19 females). The items dysphagia, aspiration, penetration, pharyngeal residue, and tongue dysfunction were extracted from the videofluorography data. For the ALS evaluation, the total score of ALSFRS-R and the Modified Norris Scale (Limb NorrisScale (Lim) and Norris Bullbar Scale (Bul)) were used. Dysphagia symptoms were noted in 86%, and pharyngeal residue and tongue dysfunction were noted at a high frequency (75% or higher). The association between the ALS evaluation scale and dysphagia was investigated. The ALSFRS-R and Lim scores were not related to the dysphagia symptom. The Bul scales scores were low in patients with aspiration, penetration, and tongue dysfunction. It was clarified that the swallowing function was reduced in patients with bullbar symptoms on the ALS evaluation scale.We suggest that it is necessary to both safely promote oral ingestion based on evaluation of the swallowing function early after the onset of ALS, and also to adopt measures against aspiration and suffocation.
