The Essentials: Dysphagia and Neuromuscular Disease

presented by Angela Mansolillo, MA/CCC-SLP, BCS-S

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Financial: Angela Mansolillo receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.

Non-Financial: Angela Mansolillo has no competing non-financial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Video Runtime: 36 Minutes, Learning Assessments: 12 Minutes

Dysphagia is a symptom, not a disease unto itself. Difficulty swallowing can be a symptom of a wide variety of medical diagnoses. The underlying diagnosis is a critical factor to consider when developing a treatment approach. Dysphagia clinicians must guard against a "one-size-fits-all" approach and instead develop an understanding of the causative factors and pathophysiology of swallowing disorders in each disease process.

This course will discuss dysphagia in the setting of neuromuscular disease, including multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), multisystem atrophy, Huntington's disease, and myasthenia gravis. The characteristics of dysphagia in patients with neuromuscular disease will be reviewed as they manifest themselves in each specific disease. Considerations for assessment of these patients will be discussed, including respiratory functions, fatigue, and potential for cough. The evidence base for treatment strategies specific to neuromuscular disease will be examined, with a focus on fatigue management, respiratory function, and positioning. Participants will be provided with an opportunity for problem-solving through case review.

This course is appropriate for dysphagia clinicians working in medical settings, including acute care, outpatient rehabilitation, inpatient rehabilitation, and long-term care.

Meet Your Instructor

Angela Mansolillo, MA/CCC-SLP, BCS-S

Angela Mansolillo, MA/CCC-SLP, BCS-S, is a speech-language pathologist and board-certified specialist in swallowing disorders with more than 25 years of experience. She is currently a senior speech-language pathologist at Cooley Dickinson Hospital in Northampton, Massachusetts, where she provides evaluation and treatment services for adults and children with dysphagia and is involved in program planning and…

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1. What the Dysphagia Clinician Needs to Know

This chapter will provide an overview of neuromuscular diseases for the dysphagia clinician. Multiple sclerosis, amyotrophic lateral sclerosis, myasthenia gravis, Huntington's disease, and multisystem atrophy will be discussed to provide the clinician with an understanding of the relationships between swallowing and neuromuscular diseases.

2. Neuromuscular Disease and Dysphagia

This chapter will describe dysphagia as it manifests in each of the neuromuscular disease processes. Signs and symptoms of dysphagia will be reviewed, and factors specific to assessment of these patients will be discussed, including respiratory muscle function, fatigue and endurance issues, and potential for cough. The role of periodic instrumental assessment will also be reviewed.

3. Intervention Strategies

This chapter will provide a discussion of the evidence base for management strategies for patients with neuromuscular disease. Intervention techniques that have been specifically targeted for these patients will be highlighted, including compensatory strategies, positioning and seating, and fatigue management. The current evidence base for exercise in neuromuscular disease will also be reviewed.

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