Introduction
Dysphagia is defined as a difficulty in swallowing saliva, liquids, foods, and medications of all consistencies (Murry & Carrau, 2012). Dysphagia is one of the most significant problems that plague individuals with amyotrophic lateral sclerosis (ALS). ALS, a degenerative neurological disease, slowly degenerates the swallowing function of an individual, most commonly in the oral and pharyngeal phases of swallowing (Stand, Miller, Yorkston, & Hilltel, 1996; Ertekin, Aydogdu, Yuceyar, Kiylioglu, Tarlaci & Uludag, 1999). According to Clave, P., De Kraa, M., Arreola, V., Girvent, M., Farre, R., Palomera, E., & Serra-Prat, M. (2006) 60% of patients with ALS have complaints of oropharyngeal dysphagia which can cause reduced oral feeding, along with malnutrition, dehydration, and aspiration. The progression of swallowing dysfunction is usually seen within several months after the onset of the disease (Ertekin et. al, 1999) and eventually begins to impact a person's ability to safely and effectively swallow, resulting in an ultimate inability to ingest food by mouth. Due to the bulbar involvement in ALS, there is a higher risk of pulmonary aspiration and malnutrition (Murry & Carrau, 2013) along with other secondary effects, including aspiration pneumonia, dehydration, and weight loss. These secondary characteristics can greatly impact the quality of life of these individuals and prevent the adequate intake of food, water, or medications by mouth.
Swallowing stages affected in ALS
Drooling, an early indication of oral phase disturbance, presents itself in ALS patients. Chapman (2013) also describes additional oral phase characteristics of individuals with ALS with early tongue and lip movement, increased meal duration, dif...
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...). San Diego, CA: Plural Publishing.
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There is no cure for ALS at this time and treatment is focused on management of the symptoms, involving a combination of physical therapy, occupational therapy, and speech, respiratory, and nutritional therapies. Moderate exercise may help maintain muscle strength and function. Drugs can also treat excessive saliva and drooling, and speech therapy can help compensate for loss of muscular control of the mouth. As the disease progresses and muscular degeneration spreads throughout the body, various devices may provide support, such as ankle braces, neck collars, reclining chairs, wheelchairs, and hospital beds. Respiratory support and feeding tubes are required when the person loses cont...
According to ALS Association (2016, para. 1), “Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in Amyotrophic Lateral Sclerosis eventually leads to their demise.” When our motor neurons die, our brain can no longer control our muscle movement. The survival time for a person living with Amyotrophic Lateral Sclerosis is up to ten years because eventually a person’s body will shut down completely. According to the Mayo Clinic (2016, para. 2), “As the disease advances and nerve cells are destroyed, your muscles progressively weaken. This eventually affects chewing, swallowing, speaking and breathing.” This disease is very scary to live with because you eventually die from
Neurodegeneration is used mainly for diseases that are characterised by progressive loss of structure and function of neurons. There are many neurodegenerative diseases including amyotrophic lateral sclerosis that...
Hypokinetic Dysarthria is a motor speech disorder that is often associated with Parkinson’s disease (PD). It can occur when there is interference in the basal ganglia control circuit. These disruptions can include “degenerative, vascular, traumatic, infectious, inflammatory, neoplastic, and toxic-metabolic diseases (Duffy, 2013, p. 176).” Damage to the basal ganglia control circuit results in reduced range of motion as well as the inability to inhibit involuntary movements. Hypokinetic dysarthria is most commonly caused by PD; a progressive, neurogenic disease that is characterized by tremor, rigidity, slowness of movement, and incoordination. Eighty-seven percent of hypokinetic dysarthria cases are associated with degenerative disease (Duffy, 2013).
It is suggested by Henderson (1998) that breathlessness in the UK today is a common and complex subjective set of symptoms. A vast range of medical and lifestyle choices cause and exacerbate breathlessness, which can be a frightening and sometimes a painful experience for the patient. A nurses interaction with a patient can help alleviate and reduce these episodes and make a substantial difference to patients both in the community and hospital setting.
"Dementia: Hope Through Research." National Institute of Neurological Disorders and Stroke (NINDS). National Institute of Neurological Disroders and Stroke, 23 Mar. 2011. Web. 29 Nov. 2011. .
Parkinson’s disease affects patients in various ways with the most observable being muscle weakness, tremor, and rigidity; these symptoms directly influence and reduce the function of the respiratory and phonatory systems. Articulatory, velopharyngeal, laryngeal, and respiratory muscles lose control and some function due to the loss of dopamine in the central nervous system. Facial expression in Parkinson's patients can appear emotionless or diminished. Parkinson’s disease decreases the fine movements of the tongue and jaw that are imperative to articulation. This reduced oral muscular control is also associated with hypoesthetic oropharynx function. With this loss of key sensory stimuli, patients with Parkinson’s disease...
Although Alzheimer’s disease appears to be the most common cause of dementia, “more than 50 conditions are associated with dementia, including degenerative ...
Amyotrophic lateral sclerosis, or ALS, is a degenerative disease affecting the human nervous system. It is a deadly disease that cripples and kills its victims due to a breakdown in the body’s motor neurons. Motor neurons are nerve cells in the brainstem and spinal cord that control muscle contractions. In ALS, these neurons deteriorate to a point that all movement, including breathing, halts. Muscle weakness first develops in the muscles of body parts distant from the brain, such as the hands, and subsequently spreads through other muscle groups closer to the brain. Such early symptoms as this, however, can hardly be noticed.
Imagine if you loss control of your body but your mind stayed unaffected. You would be a prisoner in your own body, all leading up to your death sentence. That is the sad fate for the people diagnosed with Amyotrophic lateral sclerosis (ALS). “Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder was first described by Ran in 1850. This description was then expanded in 1873 by Charcot, who emphasized the involvement of the corticospinal tracts. In the United States, ALS is often referred to as Lou Gehrig's disease, after the famous ball player who was stricken by the disease in the midst of his career. (Yale School of Medicine, 2014)” In this paper will go through the definition, the process, the signs, the risk factors, etiology, and discus the known people that have suffered with this terminal disease.
There is no quick and easy way to diagnose Alzheimer’s disease. In fact a diagnosis can only be conclusively arrived at following autopsy of the ...
Autophagia is eating the parts of one’s own body, having the cases range from very minor instances to very severely (Lo, Schreuder 2014; Hanson, 2014). It can also be considered from a biological standpoint, the body naturally consuming its own tissues (Hanson, 2014). Categorizing autophagia as a disorder depends on a person’s personal opinion, due to the variety of factors associated with the cause. As viewed by some, it is primarily the result of people with personality disorders whom are trying to rid themselves of associated negative aspects. (Yilmaz, Uyanik, Sengül, Yaylaci, Karciolju, Serinken, 2014). Therefore, it becomes seen as the symptom of other disorders, rather than a disorder. Autophagia is referred to in many different manners, su...
With motor neurone disease it attacks the nerves, in the brain and spinal cord. This means messages gradually stop reaching muscles, which leads to weakness and wasting. In the case study the
This is a neurodegenerative disease, meaning it results in progressive loss or death of neurons. It often starts off with effecting simple motor skills like writing and holding things, after a few months usually patients start losing the ability to walk, talk, or move any of their limbs. Although the brain trauma is what causes it, ALS has little-no-effect on the brain. This fatal disease is typically diagnosed around age 60 and most patients are given about 3-5 years to live after being diagnosed. It has been found that 10% of cases are shown as genetic. It was brought to attention that athletes were beginning to get diagnosed with ALS at a younger age than most. After extensive research in the early 2000’s, Brain Analyst, Dr. Mckee ran tests and finally came to the conclusion that the toxic proteins in the brains of ALS patients were coming from repeated blows to the head. It was then made evident why so many athletes in contact sports such as football, soccer, boxing, etc… were being diagnosed at such a young age and more frequently than
The clinical picture in dementia is very similar to delirium, except for the course. Delirium is an acute transitory disorder. By contrast Dementia is a long term progressive disorder (with the exception of the reversible dementias). The course of AD can range anywhere from 1.5 to 15 years with an average of about 8.1 years (Terry , 1988). AD is usually divided into three stages mild, moderate, and severe. Throughout these stages a specific sequence of cognitive deterioration is observed (Lezak, 1993). The mild stage begins with memory, attention, speed dependent activities, and abstract reasoning dysfunction. Also mild language impairments begin to surface. In the moderate stage, language deficits such as aphasia and apraxia become prominent. Dysfluency, paraphasias, and bizzare word combinations are common midstage speech defects. In the severe stage the patient is gradually reduced to a vegetative state. Speech becomes nonfluent, repetitive, and largely non-communicative. Auditory comprehension is exceedingly limited, with many patients displaying partial or complete mutism. Late in the course of the disease many neuropsychological functions can no longer be measured. Also primitive reflexes such as grasp and suck emerge. Death usually results from a disease such as pneumonia which overwhelms the limited vegetative functions of the patient.