2022 Volume 37 Issue 3 Pages 246-254
Progressive supranuclear palsy is an irreversible and progressive neurological disorder. This study reports the case of a patient with progressive supranuclear palsy and gastrostomy tube after suffering difficulty in oral intake who received oral health care for 3 years until the final stage of his life.
The patient was a 71-year-old male. The main complaint from the facility staff was the assessment of food form and eating behavior. He had poor oral hygiene care, missing molars, and did not wear dentures. We performed pre-prosthodontic treatment before making partial dentures, and performing dysphagia rehabilitation therapy and oral hygiene management. He was hospitalized because of aspiration pneumonia 1 year after the first visit to us. After leaving the hospital, videoendoscopic evaluation of swallowing was carried out and a high risk of aspiration was found. Therefore, we suggested stopping oral intake. However, his guardian wished to continue oral intake, so we provided nutrition guidance to avoid weight loss and undernutrition. An oral intake plan was prepared in collaboration with a multidisciplinary team. Two years after his first visit, aspiration was confirmed clearly by videofluoroscopic examination of swallowing. Therefore, we discussed with the guardian and explained the necessity of discontinuing oral intake. After gastrostomy surgery, he received end-of-life care until his death at the age of 74.
From this study, although oral intake was suspended because of progressive supranuclear palsy, we learned that by maintaining the quality of oral health, oral intake until the final stage of life enables a human being to live as such. Therefore, it is important to manage oral health care and to perform dysphagia rehabilitation continuously.
