Oropharyngeal dysphagia in patients with multiple sclerosis: do the disease classification scales reflect dysphagia severity?
Multiple sclerosis is a neurological disease that involves swallowing disorders. Many studies have shown an association between neurological and swallowing performance, but results have been conflicting.


OBJECTIVE
To identify the frequency of dysphagia in patients with multiple sclerosis and neurological indicators that can represent the performance of swallowing.


METHODS
In this study (cross-sectional) 120 Multiple Sclerosis patients underwent Functional Assessment of Swallowing by flexible nasal-pharyngo-laryngoscopy and the results were compared with the scores of the rating scales: (Clinical Evolving Forms of Disease, Functional Disability Scale for and Scale Systems Extended Functional Disability [Kurtzke Expanded Disability Status Scale]).


RESULTS
Dysphagia was found in 90% of patients. Among the clinical forms of the disease, the progressive forms (primary progressive and secondary progressive) were more frequently associated with severe dysphagia, while the relapsing-remitting form presented more often mild and moderate dysphagia. Regarding the Disability Scale for Functional Systems, cerebellar function, brainstem function and mental health were associated with dysphagia, especially in the severe form. Regarding the Extended Functional Disability Scale, higher scores were associated with severe dysphagia.


CONCLUSIONS
Dysphagia is common in MS patients, especially in those with greater impairment of neurological functions.
Department of Otorhinolaryngology, School of Medical Sciences, Santa Casa de São Paulo. murano@uol.com.br
Alessandro Murano Ferré
AM
Fernandes
André de Campos
Ade C
Duprat
Cláudia Alessandra
CA
Eckley
Leonardo da
Ld
Silva
Roberta Busch
RB
Ferreira
Charles Peter
CP
Tilbery
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003680:Deglutition Disorders / Q000145:classification / Q000175:diagnosis / Q000209:etiology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000145:classification / Q000150:complications*; D012720:Severity of Illness Index; D055815:Young Adult