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3 results

  • Case 62 - Inclusion Body Myositis (IBM)

  • from Myopathies
  • Jessica E. Hoogendijk, University Medical Center Utrecht, Marianne de Visser, Amsterdam University Medical Center, Pieter A. van Doorn, Erasmus MC, University Medical Center, Rotterdam, Erik H. Niks, Leiden University Medical Center
  • Book:
    Neuromuscular Disease
    Published online:
    29 November 2024
    Print publication:
    19 December 2024, pp 256-259

  • Summary

    A 64-year-old man suffered from progressive swallowing difficulty, in particular of solid food. There was a feeling of food getting stuck. He needed to take small bites and coughed while he was eating. Choking occurred frequently, and sometimes food came out his nose. He lost 7 kg over the past year. Gradually, drinking also became difficult. His GP first referred him to an ENT specialist and subsequently to a gastroenterologist who referred him to a neuromuscular centre. He was treated with Botox injections in the cricopharyngeal muscle, and this ameliorated his swallowing problems for about a year. He did not complain about limb weakness, diplopia, drooping eyelids, slurring of speech, shortness of breath, or muscle twitching. Family history was unremarkable.

  • Inclusion body myositis and dysphagia. Presentation, intervention and outcome at a swallowing clinic

  • M Shrivastava, C Harris, S Holmes, S Brady, S Winter
  • Journal:
    The Journal of Laryngology & Otology / Volume 137 / Issue 2 / February 2023
    Published online by Cambridge University Press:
    02 March 2022, pp. 213-218
    Print publication:
    February 2023
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  • Objective

    This study reviewed patients with inclusion body myositis who were referred for assessment of dysphagia at a tertiary swallow clinic. It describes symptoms at presentation, imaging and management strategies.

    Method

    A retrospective review of electronic patient records was performed between 2016 and 2020.

    Results

    Twenty-four patients were included, with a mean age of 72 years. Baseline modified Sydney Swallow Questionnaires identified problems with hard or dry food, food sticking, and repeated swallowing. Twenty-two patients had a Reflux Symptom Index score that could indicate significant reflux. Video swallow identified specific problems, including tongue base retraction (96 per cent) and residual pharyngeal pooling (92 per cent). Seven patients (30 per cent) had features of aspiration on imaging despite a median penetration-aspiration scale score of 2. Four patients received balloon dilatation, and two patients underwent cricopharyngeal myotomy.

    Conclusion

    This study helped to profile features of dysphagia in patients with inclusion body myositis. More evidence is needed to determine the most effective management pathway for these patients.