DYSPHAGIA

吞咽困难
  • 文章类型: Journal Article
    背景:吞咽复杂涉及感觉运动系统,整合上消化道和呼吸功能的关键。吞咽困难,具有挑战性的吞咽,经常引发焦虑和抑郁,深刻影响生活质量(QOL)。了解以患者为中心的症状对于评估吞咽困难的QOL影响至关重要。
    目的:本研究旨在开发和验证泰米尔语症状特异性吞咽困难生活质量问卷(SSDQOL-T)。
    方法:SSDQOL-T是在泰米尔语中开发的,并经过了严格的内容验证。该问卷被用于120名正常人和32名吞咽困难患者,评估各种吞咽困难及其QOL影响。
    结果:结果表明SSDQOL-T具有良好的内部一致性(Cronbach'sα=0.78)。各年龄组在吞咽能力和生活质量方面存在显著差异,老年人出现症状加剧。在健康成年人和吞咽困难的所有子域之间,平均得分均具有很高的意义,p值为0.0005。被发现具有重要意义的症状是咳嗽/呕吐反射,返流,吞咽困难,球状感觉,机械性和退行性吞咽困难组之间比较的胃灼热和疲劳。在泰米尔语中,SSDQOL-T评分与吞咽困难障碍指数之间存在很强的相关性(r=0.89)。
    结论:SSDQOL-T问卷为评估泰米尔语人群的吞咽困难相关QOL提供了一个可靠的工具。其验证强调了其在理解吞咽困难的多维影响方面的临床相关性和实用性。本研究强调了文化敏感性评估工具在综合评估吞咽困难的QOL影响方面的重要性。
    BACKGROUND: Swallowing intricately involves sensorimotor systems, pivotal for integrating upper digestive and respiratory functions. Dysphagia, challenging swallowing, often precipitates anxiety and depression, deeply affecting the quality of life (QOL). Understanding patient-centric symptoms is vital for assessing dysphagia\'s QOL impact.
    OBJECTIVE: This study aimed at developing and validating the Symptom Specific Dysphagia Quality of Life Questionnaire in Tamil (SSDQOL-T).
    METHODS: SSDQOL-T was developed in Tamil and underwent rigorous content validation. This questionnaire was administered to 120 normal individuals and 32 dysphagia patients, assessing various swallowing difficulties and their QOL impact.
    RESULTS: Results indicate SSDQOL-T\'s good internal consistency (Cronbach\'s α = 0.78). Significant differences in swallowing ability and QOL were noted across age groups, with older adults experiencing heightened symptoms. A high significance in mean score was obtained between healthy adults and dysphagia across all sub-domains with a \'p-value\' of 0.0005. Symptoms that were found to have high significance were cough/gag reflex, regurgitation, odynophagia, globus sensation, heartburn and tiredness when compared between mechanical and degenerative dysphagia group. Strong correlations were found between SSDQOL-T scores and the Dysphagia Handicap Index in Tamil (r = 0.89).
    CONCLUSIONS: The SSDQOL-T questionnaire provides a robust tool for evaluating dysphagia-related QOL in the Tamil-speaking population. Its validation underscores its clinical relevance and utility for understanding the multidimensional impact of dysphagia. This study emphasizes the importance of culturally sensitive assessment tools in comprehensively evaluating dysphagia\'s QOL implications.
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  • 文章类型: Journal Article
    老年人吞咽困难和发音困难的发生率增加,两者都对生活质量有深远的影响,并且经常被诊断不足。我们试图更好地了解这些投诉的患病率以及在老年病诊所中患者报告的筛查计划的潜在效用。
    使用IRB批准的横断面调查和回顾性队列设计,我们招募了在老年病学学术诊所寻求治疗的新患者.我们使用了三个经过验证的问卷来评估自我报告的吞咽困难,发音困难,和药丸吞咽困难:饮食评估工具-10(EAT-10),语音障碍索引-10(VHI-10),还有PILL-5.在任何问卷中筛查呈阳性的患者被推荐给喉科医师进行进一步评估。对PILL-5筛查阳性的患者也被推荐给我们的老年药剂师。
    在接受调查的300名患者中,平均年龄为76岁(SD8.46).共有82名(27.3%)患者筛查为阳性(EAT-10为73名,PILL-5为10名,VHI-10为13名),并提供转诊,其中36人接受。与筛查阴性的患者相比,这些阳性筛查患者服用了更多的处方药(p=.024),并且GDS评分更高(p<.001)。
    许多在我们中心寻求综合治疗的新患者在经过验证的问卷中积极筛查吞咽困难和/或发声障碍。老年患者可能会受益于这些疾病的综合筛查,以确定是否需要进一步评估。尚不清楚这些调查工具是否适用于非耳鼻喉科诊所。
    III.
    UNASSIGNED: Older adults suffer from increased rates of dysphagia and dysphonia, both of which have a profound effect on quality of life and are often underdiagnosed. We sought to better understand the prevalence of these complaints and the potential utility of a patient-reported screening program in a geriatrics clinic.
    UNASSIGNED: Using an IRB-approved cross-sectional survey and retrospective cohort design, we recruited participants from a population of new patients seeking care at an academic geriatrics clinic. We used three validated questionnaires to assess self-reported dysphagia, dysphonia, and pill dysphagia: the Eating-Assessment Tool-10 (EAT-10), the Voice Handicap Index-10 (VHI-10), and the PILL-5. Patients who screened positive on any questionnaire were offered referral to a laryngologist for additional evaluation. Patients who screened positive on the PILL-5 were also offered referral to our geriatric pharmacist.
    UNASSIGNED: Among our 300 patients surveyed, the mean age was 76 (SD 8.46). A total of 82 (27.3%) patients screened positive (73 on EAT-10, 10 on PILL-5, 13 on VHI-10) and were offered referral, of which 36 accepted. These positive screening patients took more prescription medications (p = .024) and had a higher GDS score (p < .001) when compared to the patients who screened negative.
    UNASSIGNED: Many new patients seeking generalized care at our center screened positively for dysphagia and/or dysphonia on validated questionnaires. Geriatric patients may benefit from integrating screening for these disorders to identify the need of further evaluation. It is unknown if these survey tools are appropriate in a non-otolaryngology clinic.
    UNASSIGNED: III.
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  • 文章类型: Journal Article
    自我评估问卷是必要的,以量化的损害和损害对生活质量的影响,前提是这些问卷以患者的母语提供。没有问卷来评估讲卡纳达语的个体口咽吞咽困难的症状严重程度。悉尼燕子问卷(SSQ)是评估吞咽困难症状的一种明确工具,尤其是口咽吞咽困难患者。SSQ是一个简单易懂的问卷。因此,本研究旨在适应和验证卡纳达语的SSQ。英文版的SSQ被翻译成卡纳达语,并对两组讲卡纳达语的本地参与者进行了管理-第1组包括53名被诊断患有口咽吞咽困难的参与者(66.49+12.65岁),第2组包括53名年龄和性别匹配的卡纳达语人,他们的吞咽能力正常,没有吞咽障碍的病史和症状。Cronbach的α被用来评估重测可靠性。使用分裂半相关性评估内部一致性。通过确定KSSQ的总分与Kannada版本的吞咽困难指数(DHI)之间的相关性来衡量KSSQ(KSSQ)的同时有效性。通过比较两组参与者之间的KSSQ得分来评估判别效度。结果表明,KSSQ具有良好的重测可靠性,内部一致性强,以及良好的并发效度和判别效度。因此,据推断,KSSQ是评估吞咽困难症状的有效和可靠的工具,尤其是讲卡纳达语的口咽吞咽困难患者。
    Self-rating questionnaires are necessary to quantify the impairment and the impact of impairment on the quality of life, provided that these questionnaires are delivered in the patient\'s native language. There are no questionnaires to assess the symptom severity of oropharyngeal dysphagia in Kannada-speaking individuals. The Sydney Swallow Questionnaire (SSQ) is one such explicit tool to assess the symptoms of dysphagia, especially among patients with oropharyngeal dysphagia. The SSQ is a simple and easy-to-understand questionnaire. Therefore, the present study aimed to adapt and validate the SSQ in Kannada. English version of the SSQ was translated to Kannada and was administered to two groups of native Kannada-speaking participants - Group 1 included 53 participants (66.49 + 12.65 years) diagnosed with oropharyngeal dysphagia, and Group 2 included 53 age and gender-matched native Kannada speakers with normal swallowing ability with no history and symptoms of swallowing disorders. Cronbach\'s alpha was used to assess the test-retest reliability. Internal consistency was assessed using the split-half correlation. The concurrent validity of the Kannada version of SSQ (KSSQ) was measured by determining the correlation between the total scores of KSSQ and the Kannada version of Dysphagia Handicap Index (DHI). The discriminant validity was assessed by comparing the KSSQ scores between the participants of both groups. The results indicated that the KSSQ had excellent test-retest reliability, strong internal consistency, and good concurrent and discriminant validity. Therefore, it was inferred that the KSSQ is a valid and reliable tool for assessing the symptoms of dysphagia, especially among Kannada-speaking patients with oropharyngeal dysphagia.
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  • 文章类型: Journal Article
    背景虽然大多数关于吞咽困难治疗的研究都集中在住院患者身上,对门诊设置的关注较少,尤其是耳朵,鼻子,和咽喉(耳鼻喉科)诊所。此外,虽然问卷通常用作吞咽困难管理中的筛查工具,它们与肺炎发生率或持续口服等结局的相关性很少讨论.本研究旨在评估耳鼻喉科门诊治疗吞咽困难的有效性,包括主观症状的改善,并评估问卷的作用。方法总的来说,59名患者(38名男性和21名女性),年龄在53-93岁(平均年龄=79岁)参加了门诊吞咽诊所。所有参与者都保留了足够的日常生活能力,可以独立访问医院,并可以口服食物,也不需要管喂食。使用问卷评估主观症状。由耳鼻喉科医师并通过吞咽内窥镜检查进行吞咽评估。一位语言病理学家领导了吞咽康复,其中包括鼓励家庭参与和家庭实践。结果报道的最常见的问题是在进餐时咀嚼。59名患者中,22例连续门诊康复。其中,17(77%)显示改善;11在主观症状和纤维内窥镜吞咽评估(FEES)评分方面均有改善,只有五个主观症状,只有一个在费用中得分。5例患者未表现出改变/恶化的状况。结论问卷被证明是一种有用的筛查工具,但在预后评估方面不足。研究结果表明,问卷中的信息应用于衡量治疗效果,注意到一些病例仅显示主观症状的改善。
    Background While most research on dysphagia treatment has focused on inpatients, less attention has been given to outpatient settings, particularly in ear, nose, and throat (ENT) clinics. Additionally, while questionnaires are commonly used as screening tools in dysphagia management, their correlation with outcomes such as pneumonia incidence or sustained oral intake is rarely discussed. This study aimed to evaluate the effectiveness of outpatient treatment in ENT clinics for dysphagia, including improvement in subjective symptoms, and to assess the role of the questionnaire. Methodology In total, 59 patients (38 males and 21 females) aged 53-93 years (mean age = 79 years) attended the outpatient swallowing clinic. All participants retained sufficient ability in activities of daily living to independently visit the hospital and could orally ingest food, and none required tube feeding. Subjective symptoms were evaluated using the questionnaire. Swallowing assessments were conducted by an otolaryngologist and via swallowing endoscopy. A speech-language pathologist led the swallowing rehabilitation, which included encouraging family involvement and home practice. Results The most frequent issue reported was munching during meals. Of the 59 patients, 22 underwent continuous outpatient rehabilitation. Of these, 17 (77%) showed improvement; 11 had improvement in both subjective symptoms and fiberoptic endoscopic evaluation of swallowing (FEES) scores, five in subjective symptoms only, and one in FEES scores only. Five patients showed no change/worsening conditions. Conclusions The questionnaire proved useful as a screening tool but fell short in terms of prognosis estimation. The findings suggest that information from the questionnaire should be used to gauge treatment effectiveness, noting that some cases showed improvement in subjective symptoms alone.
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  • 文章类型: Journal Article
    背景:吞咽和发声之间的复杂关系,分享解剖学和生理学基础,强调了对综合治疗方法的临床需求。现有的干预措施通常孤立地处理这些功能,忽略它们相互关联的动态。
    目的:设计并验证将吞咽困难治疗技术(动作/锻炼)纳入语音康复的交叉治疗方案。该协议旨在利用吞咽和发声的共享生物力学组件,以同时改善患有潜在喉功能减退病理的患者的两种功能。
    方法:采用描述性研究设计,由三个阶段组成:以德国研讨会形式进行全面的文献综述和专家讨论,以概念化方案;吞咽动作/练习的详细分析和分类;以及由七名专家组成的小组通过结构化评估工具进行的内容验证。该过程综合了运动学习和运动生理学原理,保证了方案的临床适用性和理论连贯性。
    结果:开发的交叉治疗方案将四个核心吞咽治疗技术结合到语音治疗程序中。选定的吞咽治疗技术针对喉偏移和声带闭合,因为它们是吞咽和发声的关键组成部分。对于大多数项目,专家验证产生的内容有效性系数超过0.90,表明对协议相关性的高度共识,清晰度,和适用性。根据反馈进行了调整,增强协议的精确性和用户友好性。
    结论:我们提出了一个新的,基于证据的治疗方案语音和吞咽困难引起的喉功能减退病理。它的发展标志着朝着弥合吞咽和语音治疗之间的差距迈出了重要的一步。需要未来的实证研究来评估其在临床环境中的有效性。
    BACKGROUND: The intricate relationship between swallowing and phonation, sharing anatomical and physiological substrates, underscores a clinical demand for integrated therapeutic approaches. Existing interventions often address these functions in isolation, overlooking their interconnected dynamics.
    OBJECTIVE: To design and validate a cross-therapy protocol incorporating dysphagia therapy techniques (maneuvers/exercises) into voice rehabilitation. This protocol aims to exploit the shared biomechanical components of swallowing and phonation to improve both functions simultaneously in patients with underlying hypofunctional laryngeal pathology.
    METHODS: A descriptive research design was employed, consisting of three phases: a comprehensive literature review and expert discussions in a German seminar format to conceptualize the protocol; detailed analysis and categorization of swallowing maneuvers/exercises; and content validation by a panel of seven experts through a structured evaluation instrument. The process integrated motor learning and exercise physiology principles to ensure the protocol\'s clinical applicability and theoretical coherence.
    RESULTS: The developed cross-therapy protocol incorporates four core swallowing therapy techniques to voice therapy procedures. Selected swallowing therapy techniques target laryngeal excursion and vocal fold closure because they are critical components of swallowing and phonation. Expert validation yielded a Content Validity Coefficient exceeding 0.90 for most items, indicating high consensus on the protocol\'s relevance, clarity, and applicability. Adjustments were made based on feedback, enhancing the protocol\'s precision and user-friendliness.
    CONCLUSIONS: We present a novel, evidence-based therapy protocol for voice and swallowing difficulties resulting from hypofunctional laryngeal pathology. Its development marks a significant step toward bridging the gap between swallowing and voice therapy. Future empirical studies are needed to assess its effectiveness in clinical settings.
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  • 文章类型: Journal Article
    背景:皮质基底变性(CBD)是一种临床异质性神经退行性疾病,病理检查对于明确诊断至关重要。本研究探讨了经病理证实的CBD的日本患者的临床特征。
    方法:我们回顾了在我们研究所连续尸检的经病理证实的CBD的日本患者的数据。临床数据来自医疗记录和临床病理会议。
    结果:在最初审查的34例患者中,由于缺乏详细的临床数据,3例被排除.其余31名患者中,16人是男性,15人是女性。发病和死亡的平均年龄为63.3±6.7(51-79)岁和69.1±6.9(54-86)岁,分别。中位病程为6.0(2.5-12)年。临床表型如下:进行性核上性麻痹综合征(PSPS;n=20,64.5%),可能或可能的皮质基底综合征(n=6,19.4%),额叶行为空间综合征(n=4,12.9%),原发性进行性失语症的非流利/语法变体(n=1,3.2%)。此外,28例(90.3%)患者出现吞咽困难,中位潜伏期为3.5(1.0-10.0)年,22例(71.0%)接受管饲的患者比未接受管饲的患者存活时间更长(P=0.013)。
    结论:与西方人群相比,PSPS的高患病率可能是日本CBD患者的临床特征.此外,许多早期潜伏期患者会出现吞咽困难,并可能缩短生存期。管饲有助于延长CBD患者的生存期。
    BACKGROUND: Corticobasal degeneration (CBD) is a clinically heterogeneous neurodegenerative disorder, for which pathological investigations are essential for a definitive diagnosis. This study explored the clinical characteristics of Japanese patients with pathologically confirmed CBD.
    METHODS: We reviewed the data of Japanese patients with pathologically confirmed CBD who were consecutively autopsied at our institute. Clinical data were obtained from medical records and clinicopathological conferences.
    RESULTS: Of the 34 patients initially reviewed, three were excluded because of a lack of detailed clinical data. Of the remaining 31 patients, 16 were men and 15 were women. The mean ages at onset and death were 63.3 ± 6.7 (51-79) years and 69.1 ± 6.9 (54-86), respectively. The median disease duration was 6.0 (2.5-12) years. The clinical phenotypes were as follows: progressive supranuclear palsy syndrome (PSPS; n = 20, 64.5 %), probable or possible corticobasal syndrome (n = 6, 19.4 %), frontal behavioral-spatial syndrome (n = 4, 12.9 %), nonfluent/agrammatic variant of primary progressive aphasia (n = 1, 3.2 %). Furthermore, 28 (90.3 %) patients exhibited dysphagia with a median latency of 3.5 (1.0-10.0) years, and 22 (71.0 %) patients who underwent tube feeding survived longer than those who did not (P = 0.013).
    CONCLUSIONS: Compared with Western populations, a high prevalence of PSPS may be a clinical characteristic of Japanese patients with CBD. Additionally, dysphagia occurs in many patients with early latency and may shorten survival. Tube feeding contributes to the prolonged survival of patients with CBD.
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  • 文章类型: Case Reports
    一名14岁的女性迷你型Pinscher表现出舌头卷曲,吞咽困难,唾液分泌过多,和舌下腺肿胀。综合评价,包括神经和肌肉骨骼检查,血液检查,和尿液分析,除与舌头有关的体征外,没有其他异常。磁共振成像(MRI)显示枕椎-寰枢关节中的多叶囊性结构,压迫右舌下管.病变在T1加权和T2加权图像上出现脑脊液(CSF)样,在流体衰减的反转恢复T2加权图像上,与CSF相比具有高强度。扫描显示在对比增强图像上具有增强的周围区域的粘液性内容物。对该囊肿进行了手术切除和引流,临床体征明显改善。根据组织病理学和影像学发现,将背侧囊肿初步诊断为神经节囊肿。对于MRI表现和神经系统体征相似的犬,在鉴别诊断中应考虑神经节囊肿。
    A 14-year-old spayed female Miniature Pinscher presented with tongue curling, dysphagia, hypersalivation, and sublingual gland swelling. Comprehensive evaluation, including neurologic and musculoskeletal examinations, blood work, and urinalysis, revealed no abnormalities other than tongue-related signs. Magnetic resonance imaging (MRI) revealed a multilobed cystic structure in the occipito-atlanto-axial joint, compressing the right hypoglossal canal. The lesion appeared cerebrospinal fluid (CSF)-like on T1-weighted and T2-weighted images, and hyperintense compared with CSF on fluid-attenuated inversion recovery T2-weighted images. The scans suggested mucinous content with enhanced peripheral areas on contrast-enhanced images. Surgical removal and drainage of this cyst were performed, and clinical signs improved markedly. The dorsal cyst was tentatively diagnosed as a ganglion cyst based on histopathologic and imaging findings. Ganglion cysts should be considered in the differential diagnosis for dogs with similar MRI findings and neurologic signs.
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  • 文章类型: Journal Article
    声带麻痹是由喉返神经(RLN)受累引起的,手术前或切除后。利用显微外科技术对切除的边缘进行接合是RLN切除最有前途的治疗策略。RLN可以通过直接硬膜外接合或使用粘附于推荐的显微外科技术的神经移植物来修复。本文旨在传达我们对RLN切除/损伤及其后续影响的经验。我们评估了我们研究所从2018年4月到2023年9月(5年零5个月)完成的RLN维修,包括至少1年的随访。功能性口腔摄入量表(FOSI)用于评估吞咽困难,误入性风险,喉镜检查的声门间隙,和GRBAS(等级,粗糙度,呼吸,Asthenia,应变)构成了语音专家评估语音质量的基础。手术技术包括使用9-0Ethilon进行初次修复或神经移植物修复。研究中包括10名患者;其中6名(60%)为男性,中位年龄为32岁。在12个月的随访中,只有10%(n=1)被发现有吞咽困难。只有10%(n=1)的声音温和刺耳。该患者是唯一显示最小残余声门间隙的患者。百分之十(n=1)的患者在12个月时表现出B/l脊髓活动,而30%(n=3)显示受影响的声带的闪烁运动。在所有的病人中,发现相反的声带正在补偿。因此,RLN的立即修复有助于声带的一般生理适应,以改善发声并减少误吸和吞咽困难的风险,从而有助于提高生活质量。术中仔细评估后,应从军械库中选择正确的程序。
    Vocal cord paralysis results from involvement of the recurrent laryngeal nerve (RLN), either before the surgery or following excision. Coaptation of the resected edges utilising microsurgical techniques is the most promising therapeutic strategy available for RLN excision. The RLN can be repaired by direct epineural coaptation or using nerve grafts adhering to recommended microsurgical techniques. This article aims to convey our experience with RLN resections/injuries and their subsequent effects. We assessed the RLN repairs that our institute had completed from April 2018 to September 2023(5 years and 5 months) including follow-up of minimum 1 year. The Functional Oral Intake Scale (FOSI) was applied to assess dysphagia, aspiration risk, and glottic gap by laryngoscopy, and GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) comprised the basis for the assessment of voice quality by speech specialists. Surgical technique included using 9-0 Ethilon either for primary repair or for repair with a nerve graft. Ten patients were included in the study; six (60%) of them were male with the median age of 32 years. At 12-month follow-up, only 10% (n = 1) was found to have dysphagia. Only 10% (n = 1) had a mild harsh voice. This same patient was the only patient to show a minimal remnant glottic gap. Ten percent (n = 1) patient showed B/l cord mobility at 12 months, while 30% (n = 3) showed flickering movements of the affected vocal cord. In all the patients, the opposite vocal cord was found to be compensating. Thus, immediate repair of RLN is helpful along with the general physiological adaptation of vocal cords to improve phonation and reduce aspiration and dysphagia risks, thus helping to improve the quality of life. The right procedure should choose from the armoury after careful intraoperative assessment.
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  • 文章类型: Case Reports
    背景:神经胶质异位症是一种罕见的小儿颈部肿块的鉴别诊断。它在咽旁间隙的发生是非常罕见的,文献中记录的病例不到30例。
    方法:本报告详细介绍了一名4岁女孩的病例,该女孩最初发现出生时右侧腮腺区域有肿块,没有症状。经过观察,她在4岁时因吞咽困难和同一区域可见肿块而返回。随后的CT成像显示右咽旁间隙有肿块,提示手术干预。切除后的组织学检查证实了神经胶质异位症的诊断。
    结论:神经胶质异位症在儿科患者中表现出各种症状,由于缺乏将其与儿童其他颈部肿块区分开的特定放射学或临床特征,因此构成了诊断挑战。
    结论:该病例强调了在小儿颈部肿块诊断中考虑神经胶质异位症的重要性。需要进一步研究以更好地了解其临床特征和治疗方案。
    BACKGROUND: Neuroglial heterotopia represents a rare differential diagnosis for pediatric neck masses. Its occurrence in the parapharyngeal space is exceptionally uncommon, with fewer than 30 documented cases in the literature.
    METHODS: This report details the case of a 4-year-old girl initially noted to have a mass in the right parotid area at birth with no symptoms. After observation, she returned at the age of 4 with dysphagia and a visible mass in the same area. Subsequent CT imaging revealed a mass in the right parapharyngeal space, prompting surgical intervention. Histological examination after resection confirmed the diagnosis of neuroglial heterotopia.
    CONCLUSIONS: Neuroglial heterotopia manifests with various symptoms in pediatric patients, posing diagnostic challenges due to the lack of specific radiological or clinical features distinguishing it from other neck masses in children.
    CONCLUSIONS: This case highlights the significance of considering neuroglial heterotopia in pediatric neck region masses diagnoses. Further research is needed to better understand its clinical features and treatment options.
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  • 文章类型: Journal Article
    我们报告了一例74岁的帕金森病(PD)患者,患有急性吞咽困难,构音障碍,和声音嘶哑。神经系统检查和鼻咽纤维镜检查显示左侧舌咽麻痹,迷走神经,和舌下神经.没有观察到皮疹。脑脊液检测显示淋巴细胞增多,水痘-带状疱疹病毒(VZV)IgG抗体指数升高。她被诊断为带状疱疹,单侧影响多个下颅神经。尽管吞咽困难在PD患者中很常见,吞咽困难的急性加重需要仔细研究各种潜在的原因,包括VZV感染。
    We report the case of a 74-year-old woman with Parkinson\'s disease (PD) who developed acute dysphagia, dysarthria, and hoarseness. A neurological examination and nasopharyngeal fiberscopy revealed paralysis of the left glossopharyngeal, vagus, and hypoglossal nerves. No skin rash was observed. Cerebrospinal fluid testing showed lymphocytic pleocytosis, and an elevated varicella-zoster virus (VZV) IgG antibody index. She was diagnosed with zoster sine herpete unilaterally affecting multiple lower cranial nerves. Although dysphagia is common in patients with PD, acute exacerbations of dysphagia require careful investigation of various potential causes, including VZV infection.
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