Dysphagia in spinocerebellar ataxia and multiple system atrophy-cerebellar

Abstract

Dysphagia is a common sequelae of spinocerebellar ataxia (SCA) and multiple system atrophy-cerebellar (MSA-C) resulting in significant nutritional, respiratory, and psychosocial impairment. Limited prognostic or descriptive data are available to inform clinical practice. In a retrospective observational study, we examined the frequency of dysphagic features among patients with MSA-C and SCA. Medical data from 24 patients consecutively admitted to a tertiary neurological care setting over an 18-month period from January 2011 to July 2013 were included. Dysphagia was present in 92% (12 of 13) of patients with SCA and 81% (9 of 11) patients with MSA-C. Overall, there was a high degree of clinical overlap across the two disorder groups; however, secretion management issues were more pronounced in patients with SCA. Age at diagnosis correlated significantly with the number of oral phase dysphagic features in patients with MSA-C, not SCA. One-third of patients presented with signs of penetration/aspiration. Based on the high incidence of dysphagia and the subsequent risk of aspiration resulting from these symptoms, systematic and objective measurement of swallowing appears a necessary component of standard clinical care.