ABSTRACT
Multiple sclerosis (MS) refers to chronic inflammation of the central nervous system including the brain and spinal cord. Assessing for the presence of dysphagia in subjects with MS represents a challenge for neurologists in clinical practice. The aim of the present study was to verify the relationship between DYMUS scores, a patient-reported scale, and objective symptoms using the Dysphagia Outcome Severity Score (DOSS), based on fiber-optic endoscopy. Data were collected in a multicenter study. Two hundred and fifteen MS patients were enrolled, irrespective of self-reported dysphagia. DOSS revealed dysphagia in 122 subjects (56.7%). Compared with non-dysphagic subjects, the presence of dysphagia was related to more severe disability, longer disease duration, and a progressive form of the disease. A DYMUS score of 0 strongly correlated with a DOSS of 6 (sensitivity 100%) while DYMUS score of > 2 correlated with a DOSS < 7 (specificity 82%) of the self-reported scale. The DYMUS questionnaire can be a useful clinical tool for red-flagging patients who should undergo objective testing and referral to a otorhinolaryngologist.
Subject(s)
Deglutition Disorders , Multiple Sclerosis , Deglutition , Deglutition Disorders/diagnosis , Deglutition Disorders/etiology , Endoscopy , Humans , Multiple Sclerosis/complications , Surveys and QuestionnairesABSTRACT
Dysphagia in multiple sclerosis (MS) has been found to be far more frequent than expected, and should be considered a dangerous condition from its onset because of its potentially serious complications. Among the several classification scales, we use the "O'Neil severity graduation scale" for its correlation between investigation imaging and patients' symptoms. In this paper we describe our treatment plans of mild, moderate and severe dysphagia following a preliminary assessment of symptoms carried out according to the O'Neil dysphagia graduation scale.