Journal of Child Neurology

 

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0883073808315418v1
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First published on April 10, 2008, doi:10.1177/0883073808315418

Journal of Child Neurology 2008;23:919.

A more recent version of this article appeared on August 1, 2008

Article

Is Head Balance a Major Determinant for Swallowing Problems in Patients With Spinal Muscular Atrophy Type 2?

Lenie van den Engel-Hoek, BA1*, Bert J. M. de Swart, PhD1, Corrie E. Erasmus, MD2, and Imelda J. M. de Groot, MD, PhD1

1 Department of Rehabilitation, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
2 Interdisciplinary Centre for Child Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

* To whom correspondence should be addressed. E-mail: L.vandenEngel{at}cukz.umcn.nl.


  Abstract
A child with spinal muscular atrophy type 2 was referred for evaluation of eating and swallowing problems. The dysphagia evaluation demonstrated coughing during eating and drinking and occasionally stertorous when eating solid food. The video-fluoroscopic swallow study showed a late upper esophageal sphincter opening with hypopharyngeal residue, more with solid food than with thin liquid. His lumbar lordosis associated with anterior tilted pelvis and his problems with head balance due to weak neck musculature caused compensatory behavior like a retracted neck and mandible. This position negatively influences the opening of the upper esophageal sphincter. This case supported the idea that dysphagia in spinal muscular atrophy type 2 is caused by both a bulbar component as well as a treatable posture component.


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