title: Evaluation of dysphagia at the initial diagnosis of amyotrophic lateral sclerosis.
abstract: OBJECTIVE
  Dysphagia eventually occurs in amyotrophic lateral sclerosis (ALS). Swallowing in patients with ALS at their initial diagnosis was evaluated using videofluoroscopy (VF).
  
  
  METHODS
  Nineteen consecutive patients with ALS, 14 with bulbar symptoms, and 5 without them, underwent VF. Fourteen physiologic components, 6 oral and 8 pharyngeal components, were assessed during the examination.
  
  
  RESULTS
  Significantly poorer scores were observed in three of the 6 oral components and 3 of the 8 pharyngeal components in patients with bulbar symptoms. Furthermore, bolus transport from the oral cavity to pharynx, pharyngeal constriction, oral residue and pharyngeal residue were impaired in patients even without bulbar symptoms. On the other hand, pharyngoesophageal segment opening was preserved in patients even with bulbar symptoms. Bolus transport and initiation of pharyngeal swallow were correlated with the swallowing category of the ALS severity scale.
  
  
  CONCLUSIONS
  Defining types of impairment in patients with or without bulbar symptoms is useful for evaluating dysphagia in this disease. Although VF showed impairment of oral and pharyngeal phases of swallowing, the oral phase affected the eating habit in ALS at the initial diagnosis.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan. Electronic address: murono@med.kanazawa-u.ac.jp.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Murono
authors.affiliation: Department of Neurology, School of Medicine, Kanazawa University, Kanazawa, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hamaguchi
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Nakanishi
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Tsuji
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan.
authors.forename: Kazuhira
authors.initials: K
authors.lastname: Endo
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Kondo
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Wakisaka
authors.affiliation: Department of Neurology, School of Medicine, Kanazawa University, Kanazawa, Japan.
authors.forename: Masahito
authors.initials: M
authors.lastname: Yamada
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Yoshizaki
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D015331:Cohort Studies; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D004947:Esophagus / Q000000981:diagnostic imaging / Q000503:physiopathology; D005247:Feeding Behavior; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000000981:diagnostic imaging / Q000503:physiopathology; D009960:Oropharynx / Q000000981:diagnostic imaging / Q000503:physiopathology; D010614:Pharynx / Q000000981:diagnostic imaging / Q000503:physiopathology; D012720:Severity of Illness Index; D014741:Video Recording
keywords: Amyotrophic lateral sclerosis; Dysphagia; Severity scale; Videofluoroscopy