Charakterizace poruch polykání při myasthenia gravis pomocí flexibilního endoskopického vyšetření

Stáhnout PDF English version

Autoři: A. De C. A. F. De Castro; R. A. Dedivitis; D. S. Queija; L. Arakawa-Sugueno; M. A. Castro; L. L. Matos
Působiště autorů: São Paulo Medical School, University, of São Paulo, São Paulo, Brazil. ; Department of Head and Neck Surgery
Vyšlo v časopise: Cesk Slov Neurol N 2021; 84/117(4): 374-380
Kategorie: Původní práce
doi: https://doi.org/10.48095/cccsnn2021374

Souhrn

Cíl: Myasthenia gravis (MG) je autoimunitní onemocnění charakteristické slabostí a rychlou únavou jakýchkoli svalů pod volní kontrolou, které se při vyvinutém úsilí zhoršuje, s možným rozvojem poruch polykání. Cílem této studie bylo charakterizovat poruchy polykání u MG pomocí flexibilního endoskopického vyšetření (fiberoptic endoscopic evaluation of swallowing; FEES). Metody: Studie byla provedena hodnocením 37 pacientů s MG v období od května 2015 do listopadu 2016. Kromě analýzy klinických a demografických dat byli všichni pacienti vyšetřeni pomocí FEES. Výsledky: Vztah mezi výskytem laryngeální senzitivity a stázou ukázal, že u pacientů se sníženou senzitivitou dochází k stáze slin a kapalin a zejména ke statisticky významné stáze kašovité (p = 0,025) a pevné (p < 0,001) stravy. Závěr: U pacientů s MG se vyskytují poruchy polykání. U nemocných s generalizovaným postižením a větší progresí MG byly pozorovány změny v kontraktibilitě hltanu a snížení laryngeální senzitivity.

Klíčová slova:

myasthenia gravis – poruchy polykání – endoskopie – autoimunitní onemocnění – polykání

Zdroje

1. Meriggioli MN, Sanders DB. Autoimmune myasthenia gravis: emerging clinical and biological heterogeneity. Lancet Neurol 2009; 8 (5): 475–490. doi: 10.1016/S1474-4422 (09) 70063-8.

2. Hoch W, McConville J, Helms S et al. Auto-antibodies to the receptor tyrosine kinase MuSK in patients with myasthenia gravis without acetylcholine receptor antibodies. Nat Med 2001; 7 (3): 365–368. doi: 10.1038/85 520.

3. Higuchi O, Hamuro J, Motomura M et al. Autoantibodies to low-density lipoprotein receptor-related protein 4 in myasthenia gravis. Ann Neurol 2011; 69 (2): 418–422. doi: 10.1002/ana.22312.

4. Zhang B, Shen C, Bealmear B et al. Autoantibodies to agrin in myasthenia gravis patients. PLoS One 2014; 9 (3): e91816. doi: 10.1371/journal.pone.0091816.

5. Oliveira EF, Valério BCO, Cavalcante V et al. Quantitative myasthenia gravis score: a Brazilian multicenter study for translation, cultural adaptation and validation. Arq Neuropsiquiatr 2017; 75 (7): 457–463. doi: 10.1590/0004-282X20170075.

6. Grob D, Arsura EL, Brunner NG et al. The course of myasthenia gravis and therapies affecting outcome. Ann N Y Acad Sci 1987; 505: 472–499. doi: 10.1111/j.1749-6632.1987.tb51317.x.

7. Carpenter RC, Mc Donald TJ, Howard EM. The otolaryngologic presentation of myasthenia gravis. Laryngoscope 1979; 89 (6 Pt 1): 922–928. doi: 10.1288/00005537-197906000-00008.

8. Donner MW, Silbiger ML. Cinefluorographic analysis of pharyngeal swallowing in neuromuscular disorders. Am J Med Sci 1966; 251 (5): 600–616. doi: 10.1097/00 000441-196605000-00013.

9. Khan OA, Campbell WW. Myasthenia gravis presenting as dysphagia: clinical considerations. Am J Gastroenterol 1994; 89 (7): 1083–1085.

11. Gwathmey KG, Burns TM. Myasthenia gravis. Semin Neurol 2015; 35 (4): 327–339. doi: 10.1055/s-0035-1558975.

12. American Speech Language Hearing Association. Special interest division 13. Swallowing and swallowing disorders. Atlanta, GA, USA 1998.

13. Logemann JA. Swallowing physiology and pathophysiology. Otolaryngol Clin North Am 1988; 21: 613–623.

14. Logemann JA. Dysphagia: evaluation and treatment. Folia Phoniatr Logop 1995; 47 (3): 140–164. doi: 10.1159/000266348.

15. Bastian RW. Videoendoscopic evaluation of patients with dysphagia: an adjunct to the modified barium swallow. Otolaryngol Head Neck Surg 1991; 104 (3): 339–350. doi: 10.1177/019459989110400309.

16. Langmore SE, Schatz K, Olsen N. Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia 1988; 2 (4): 216–219. doi: 10.1007/BF02414429.

17. Aviv JE, Kaplan ST, Thomson E et al. The safety of flexible endoscopic evaluation of swallowing with sensory testing (FEESST): an analysis of 500 consecutive evaluations. Dysphagia 2000; 15 (1): 39–44. doi: 10.1007/s004559910008.

18. Aviv JE, Kim T, Thomson JE et al. Fiberoptic endoscopic evaluation of swallowing with sensory testing (FEESST) in healthy controls. Dysphagia 1998; 13 (2): 87–92. doi: 10.1007/PL00009561.

19. Sebastian S, Nair GP, Thomas P et al. Oropharyngeal dysphagia: neurogenic etiology and manifestation. Indian J Otolaryngol Head Neck Surg 2015; 67 (Suppl 1): 119–123. doi: 10.1007/s12070-014-07 94-3.

20. Osserman KE, Genkins G. Studies in myasthenia gravis: review of a twenty-year experience in over 1200 patients. Mt Sinai J Med 1971; 38 (6): 497–537.

21. Rosenbek JC, Robbins JA, Roecker EB et al. A penetration – aspiration scale. Dysphagia 1996; 11 (2): 93–98. doi: 10.1007/BF00417897.

22. Jung SH, Kim J, Jeong H et al. Effect of the order of test diets on the accuracy and safety of swallowing studies. Ann Rehabil Med 2014; 38 (3): 304–309. doi: 10.5535/arm.2014.38.3.304.

23. Olszewski J. Causes, diagnosis and treatment of neurogenic dysphagia as an interdisciplinary clinical problem. Otolaryngol Pol 2006; 60 (4): 491–500.

24. Koopman WJ, Wiebe S, Colton-Hudson A et al. Prediction of aspiration in myasthenia gravis. Muscle Nerve 2004; 29 (2): 256–260. doi: 10.1002/mus.10538.

25. Halama AR. Clinical approach to the dysphagic patient. Acta Otorhinolaryngol Belg 1994; 48 (2): 119–126.

26. Labeit B, Muhle P, Ogawa M et al. FEES-based assessment of pharyngeal hypesthesia: proposal and validation of a new test procedure. Neurogastroenterol Motil 2019; 31 (11): e13690. doi: 10.1111/nmo.13 690.

27. Dziewas R, auf dem Brinke M, Birkmann U et al. Safety and clinical impact of FEES: results of the FEES-registry. Neurol Res Pract 2019; 1: 16. doi: 10.1186/s42466-019-0021-5.

28. Warnecke T, Labeit B, Schroeder J et al. Neurogenic dysphagia: systematic review and proposal of a classification system. Neurology 2021; 96 (6): e876–e889. doi: 10.1212/WNL.0000000000011350.

29. Buchholz DW, Robbins J. Neurologic diseases affecting oropharyngeal swallowing. In: Pearlman AL, Schulze-Delrieu K (eds). Deglutition and its disorders: anatomy, physiology, clinical diagnosis and management. New York: Singular 1997.

30. Khan OA, Campbell WW. Myasthenia gravis presenting as dysphagia: clinical considerations. Am J Gastroenterol 1994; 89 (7): 1083–1085.

31. Oda AL, Chiappetta ALML, Annes M et al. Clinical, endoscopical and manometric evaluation of swallowing in patients with acquired autoimmune myasthenia gravis. Arq Neuropsiquiatr 2002; 60 (4): 986–995. doi: 10.1590/s0004-282x2002000600019.

32. St Guily JL, Périé S, Willig TN et al. Swallowing disorders in muscular diseases functional assessment and indications of cricopharyngeal myotomy. Ear Nose Throat J 1994; 73 (1): 34–40.

33. Manrique D. Avaliação da deglutição em crianças com paralisia cerebral tetraespástica: análise nasofibrolaringoscópica. São Paulo: Universidade Federal de São Paulo 1998.

34. Colton-Hudson A, Koopmann WJ, Moosa T et al. A prospective assessment of the characteristics of dysphagia in myasthenia gravis. Dysphagia 2001; 17 (2): 147–151. doi: 10.1007/s00455-001-0114-4.

35. Robbins J. Normal swallowing and aging. Semin Neurol 1996; 16 (4): 309–317. doi: 10.1055/s-2008-1040 989.

36. Logeman JA. Effects of aging on swallowing mechanism. Otolaryngol Clin North Am 1990; 23 (6): 1045–1056.

37. Swart BJM, Padberg GW, Engelen BGM. Less is more: treatment of aggravating behaviour in myasthenia gravis patients with dysphagia. Eur J Neurol 2002; 9 (6): 687–702. doi: 10.1046/j.1468-1331.2002.00447_3.x.

38. Umay EK, Karaahmet F, Gurcay E et al. Dysphagia in myasthenia gravis: the tip of the Iceberg. Acta Neurol Belg 2018; 118 (2): 259–266. doi: 10.1007/s13760-018-0884-1.

39. Logemann JA, Rademaker AW, Pauloski BR et al. Normal swallowing physiology as viewed by videofluoroscopy and videoendoscopy. Folia Phoniatr Logop 1998; 50 (6): 311–319. doi: 10.1159/000021473.

40. Buchholz DW. Neurologic disorders of swallowing. In: Groher ME (eds). Dysphagia: diagnosis and management. Boston: Butterworth Heinemann 1997; 53–54.