CORRELATION BETWEEN CLINICAL AND VIDEOFLUOROSCOPIC FINDINGS IN DERMATOMYOSITIS: CASE REPORT

Ano: 2013 | Volume: 17 | Número: Suplemento

Autores: Silva KGN, Yamamoto FA, Santos JG, Bonini MV.

Resumo Inglês:

INTRODUCTION: Dermatomyositis is an idiopathic inflammatory myopathy associated with characteristic cutaneous manifestations. The main manifestation of this condition is proximal and symmetric weakness of both the pelvic and shoulder girdle and the cervical musculature, and its extramuscular manifestations include dysphagia, cardiopathy, and respiratory disorders. OBJECTIVE: To correlate the clinical and videofluoroscopic findings in a patient with dermatomyositis. CASE REPORT: We report the case of a 27-year-old woman with a diagnosis of dermatomyositis and symptoms such as dysphagia and speech disorders. The speech and swallowing assessment showed hypernasality, inappropriate oral ejection, multiple swallowing, low hyo-laryngeal elevation, "wet voice," boisterous cervical auscultation during and after swallowing, constant phlegm, and a classification of level 5 in the ASHA Swallowing Severity Scale. Based on the clinical assessment, a pasty diet and viscous drinks were introduced, both of them associated with the chin-down maneuver. Swallowing videofluoroscopy showed multiple swallows, cough or phlegm followed by a swallowing event, low hyo-laryngeal and pharyngoesophageal segment opening, food stasis in the pyriform sinus, and frequent laryngeal pervasion. It's been noticed a gain with chin-down maneuver and the phlegm occurrence, as a protection and cleaning maneuver of the airways, respectively. The O'Neil Scale (1999) rated the results as mild/moderate dysphagia (level 4), and these findings were consistent with those of the clinical assessment. CONCLUSION: The videofluoroscopic assessment confirmed the laryngeal and tracheal penetration/aspiration risk that had been suspected during the prior clinic assessment.