Isolated bulbar palsy and dysphagia in children with respiratory symptoms.

Abstract

Oropharyngeal dysphagia can cause chronic aspiration leading to significant respiratory symptoms. When dysphagia is diagnosed, an underlying cause is sought. We present a case series of 15 children diagnosed aged 6 months to 5 years (mean 2y 5mo; 11 males, four females) over a 6-year period, who were found to have an isolated bulbar palsy on genioglossus electromyography, with no accompanying neurological or neurodevelopmental disorder. Eight children had dysphagia but a normal EMG. In those with isolated bulbar palsy, management included thickened fluids (n=13), cooled boiled water (n=1), and nasogastric tube feeding (n=1). Follow-up over 1 to 8 years (mean 5y) showed complete resolution in six children, improvement in four children, and no improvement in five children (including two requiring fluids via a gastrostomy). Eight children no longer had any respiratory symptoms. Isolated bulbar palsy is under-recognized and has not been reported previously as a cause of significant dysphagia in children.

• Authors: Stacey Zimmels, Ian M Balfour-Lynn, Loucas Christodoulou, Mantha Pantazi, Efterpi Pavlidou, Matthew Pitt, Maria Kinali, Naila Ismayilova
• Journal: Developmental medicine and child neurology (Dev Med Child Neurol) Vol. 64 Issue 4 Pg. 518-522 (04 2022) ISSN: 1469-8749 [Electronic] England
• PMID: 34601721 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2021 Mac Keith Press.

Topics

• Bulbar Palsy, Progressive (complications, therapy)
• Child
• Deglutition Disorders (diagnosis, etiology, therapy)
• Electromyography (adverse effects)
• Female
• Gastrostomy
• Humans
• Male