Case Report: Comprehensive management of Bulbar Motor Neuron disease in an elderly male: A Multidisciplinary case report approaching the treatment

Abstract

Abstract* Bulbar Motor Neuron Disease (MND), a specific form of amyotrophic lateral sclerosis (ALS) primarily affecting the upper and lower motor neurons in the brainstem’s bulbar region, presents a significant challenge in clinical management. This case report delves into the clinical presentation and management of an 85-year-old male patient with typical symptoms, such as left-sided weakness, dysphagia, and dysarthria, along with a history of aphasia and hypertension, underlining the complexities associated with diagnosing and managing this condition. Methods: The patient underwent a thorough clinical examination, diagnostic investigations, and imaging, leading to a confirmed diagnosis of bulbar MND. Multidisciplinary interventions were employed to addressed the diverse symptoms, including compensation therapy, swallowing function training, physiotherapy, bolus modification, behavioral adjustments, oromotor exercises, postural corrections, and sensory and neurophysiologic stimulation to enhance swallowing safety and comfort. Additionally, interventions for dysarthria and left-sided weakness encompassed speech rate control, strength training, and the use of augmentative communication aids. Results: Over a 30-day follow-up period, the patient showed improvements in dysphagia, dysarthria, and activities of daily living. The treatment strategies effectively addressed the specific challenges associated with bulbar MND, focusing on enhancing the patient’s quality of life and functional abilities. Conclusions: This case report underscores the need for a comprehensive, multidisciplinary approach to manage bulbar MND. It highlights the complexities of diagnosing and addressing the diverse symptoms and difficulties that patients with this condition encounter, emphasizing the importance of a holistic and individualized therapeutic strategy.