PDF(Pubmed)
Abstract：
Osmotic Demyelination Syndrome (ODS) is one of the primary cause of demyelination in alcoholics and malnourished resulting in various kind of clinical manifestations in pontine symptoms, neuro-behavioural symptoms movement disorders as well as speech and language and swallowing difficulties. The study was done to introspect the prognosis of swallowing therapy in a patient with ODS using MASA (Mann Assessment of Swallowing Ability). A 36 years old male with a history of regular alcohol intake and hypertensiom reported in our healthcare centre with hypoaklemia and speech, language and swallowing difficulty. Magnetic resonance imaging of the brain showed bilateral symmetrical T2 and T2 FLAIR (fluid attenuated inversion recovery) hyperintensity lesion in the bilateral basal ganglia involving the caudate nuclei, putaminal region and bilateral thalami with similar lesion along the mid brain. There were no areas of acute restriction in diffusion study. The findings suggested of Osmotic Demyelination Syndrome (ODS).When accessed with N-DAT, WAB and MASA; patient was diagnosed with Spastic Dysarthria, Transcortical Motor Aphasia and Moderate Dysphagia. Intervention was provided using speech and swallowing therapy and when introspected with MASA scores, improvement was seen within 5 days and statistically 97% of variance was seen inferring the progressing trend in the MASA scores. This study concludes that MASA can be an effective tool in introspecting the prognosis of Dysphagia in ODS and early intervention in the management of dysphasia shows positive results.
摘要：
渗透性脱髓鞘综合征（ODS）是酗酒者脱髓鞘的主要原因之一，营养不良导致脑桥症状的各种临床表现，神经行为症状运动障碍以及言语和语言和吞咽困难。这项研究是为了使用MASA（吞咽能力的Mann评估）来反思ODS患者吞咽治疗的预后。一名36岁的男性，有经常饮酒和高血压的病史，在我们的医疗中心报告患有低钾血症和言语，语言和吞咽困难。脑部磁共振成像显示双侧基底神经节中的双侧对称T2和T2FLAIR（液体衰减倒置恢复）高强度病变，涉及尾状核，质质区和双侧丘脑，沿中脑有相似的病变。扩散研究中没有急性限制区域。这些发现提示了渗透性脱髓鞘综合征（ODS）。当使用N-DAT访问时，WAB和MASA；患者被诊断患有痉挛性构音障碍，经皮质运动性失语症和中度吞咽困难。使用言语和吞咽疗法进行干预，并以MASA评分进行内省时，在5天内观察到改善,统计学上97%的方差推断了MASA评分的进展趋势.这项研究得出的结论是，MASA可以成为内省ODS吞咽困难预后的有效工具，早期干预治疗吞咽困难显示出积极的结果。
