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Dysphagia

, Volume 30, Issue 6, pp 669–673 | Cite as

Esophageal Involvement in Multiple System Atrophy

  • Hiroshige Taniguchi
  • Hideaki Nakayama
  • Kazuhiro Hori
  • Masatoyo Nishizawa
  • Makoto Inoue
  • Takayoshi Shimohata
Original Article

Abstract

The prevalence of esophageal involvement and its impact on clinical manifestations in patients with multiple system atrophy (MSA) remains unknown. We recruited 16 consecutive patients with dysphagia associated with MSA (MSA group) and 16 consecutive patients with dysphagia associated with amyotrophic lateral sclerosis (ALS group). We assessed the presence or absence of food stagnation within the esophagus using videofluorography. Food stagnation within the esophagus was observed in 16 patients (100 %; 7 severe, 9 mild) in the MSA group and in 4 patients (25 %; 4 mild) in the ALS group (P < 0.001). Follow-up videofluorography revealed that food stagnation in patients with MSA could exacerbate during the disease course. Patients with MSA and severe food stagnation showed a wide range of intraesophageal stasis by videofluorography. Among the 16 patients in the MSA group, 4 developed aspiration pneumonia and 1 died of suffocation associated with food regurgitation during continuous positive airway pressure therapy. In conclusion, food stagnation within the esophagus occurs more frequently in MSA patients with dysphagia than in ALS patients with dysphagia. Because food stagnation can cause serious complications such as aspiration pneumonia and suffocation, patients with MSA should be evaluated by videofluorography, especially those with stagnation in the esophageal phase.

Keywords

Multiple system atrophy Esophageal involvement Dysphagia Food stagnation Aspiration pneumonia Sudden death 

Notes

Acknowledgments

This study was supported in part by a Grant from the Japan Foundation for Neuroscience and Mental Health.

Compliance with Ethical Standards

Conflict of interest

None.

Supplementary material

455_2015_9641_MOESM1_ESM.docx (13 kb)
Supplemental Table 1. Clinical and videofluorographic findings in the amyotrophic lateral sclerosis group. M, male; F, female; NPPV, non-invasive positive pressure ventilation; L, Lower esophagus. Supplementary material 1 (DOCX 13 kb)
455_2015_9641_MOESM2_ESM.docx (12 kb)
Supplemental Table 2. Dysphagia outcome and severity scale (DOSS). Supplementary material 2 (DOCX 11 kb)

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Hiroshige Taniguchi
    • 1
  • Hideaki Nakayama
    • 2
  • Kazuhiro Hori
    • 3
  • Masatoyo Nishizawa
    • 4
  • Makoto Inoue
    • 5
  • Takayoshi Shimohata
    • 4
  1. 1.Department of DentistrySchool of Medicine, Fujita Health UniversityToyoakeJapan
  2. 2.Department of Respiratory MedicineTokyo Medical UniversityTokyoJapan
  3. 3.Division of Comprehensive ProsthodonticsNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
  4. 4.Department of Neurology, Brain Research InstituteNiigata UniversityNiigataJapan
  5. 5.Division of Dysphagia RehabilitationNiigata University Graduate School of Medical and Dental SciencesNiigataJapan

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