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Traumatic atlanto-occipital dislocation presenting with Dysphagia as the chief complaint: a case report.

Choi EH, Jun AY, Choi EH, Shin KY, Cho AR - Ann Rehabil Med (2013)

Bottom Line: Electromyography confirmed a right spinal accessory nerve lesion.Magnetic resonance imaging confirmed atlanto-occipital dislocation.Therefore, in survivors who are diagnosed with atlanto-occipital dislocation, any neurological symptoms should be carefully evaluated.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Medicine and Rehabilitation, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.

ABSTRACT
We report a patient with traumatic atlanto-occipital dislocation who presented with dysphagia as the chief complaint. A 59-year-old man complained of swallowing difficulty for 2 months after trauma to the neck. On physical examination, there was atrophy of the right sternocleidomastoid and upper trapezius muscles, and the tongue was deviated to the right. In a videofluoroscopic swallowing study, penetration and aspiration were not seen, food residue remained in the right vallecula and pyriform sinus, and there was decreased motion of the soft palate, pharynx and larynx. Electromyography confirmed a right spinal accessory nerve lesion. Magnetic resonance imaging confirmed atlanto-occipital dislocation. Dysphagia in atlanto-occipital dislocation is induced by medullary compression and lower cranial nerve injury. Therefore, in survivors who are diagnosed with atlanto-occipital dislocation, any neurological symptoms should be carefully evaluated.

No MeSH data available.


Related in: MedlinePlus

(A) The anteroposterior projection of the videofluoroscopic image shows much barium residue in the right vallecula after swallowing the solid component. (B) The lateral projection shows much barium residue in the vallecula and pyriform sinus after swallowing the solid component.
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Figure 1: (A) The anteroposterior projection of the videofluoroscopic image shows much barium residue in the right vallecula after swallowing the solid component. (B) The lateral projection shows much barium residue in the vallecula and pyriform sinus after swallowing the solid component.

Mentions: A videofluoroscopic swallowing study (VFSS) revealed that lip closure and jaw movement were normal, but the soft palate and tongue movements were impaired. There were decreased epiglottic inversion, laryngeal elevation and movement of pharyngeal wall and delayed pharyngeal transit time. There was no penetration or aspiration of liquid, semisolid, or solid, but a large amount of material was retained in the right vallecula and pyriform sinus (Fig. 1).


Traumatic atlanto-occipital dislocation presenting with Dysphagia as the chief complaint: a case report.

Choi EH, Jun AY, Choi EH, Shin KY, Cho AR - Ann Rehabil Med (2013)

(A) The anteroposterior projection of the videofluoroscopic image shows much barium residue in the right vallecula after swallowing the solid component. (B) The lateral projection shows much barium residue in the vallecula and pyriform sinus after swallowing the solid component.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3713304&req=5

Figure 1: (A) The anteroposterior projection of the videofluoroscopic image shows much barium residue in the right vallecula after swallowing the solid component. (B) The lateral projection shows much barium residue in the vallecula and pyriform sinus after swallowing the solid component.
Mentions: A videofluoroscopic swallowing study (VFSS) revealed that lip closure and jaw movement were normal, but the soft palate and tongue movements were impaired. There were decreased epiglottic inversion, laryngeal elevation and movement of pharyngeal wall and delayed pharyngeal transit time. There was no penetration or aspiration of liquid, semisolid, or solid, but a large amount of material was retained in the right vallecula and pyriform sinus (Fig. 1).

Bottom Line: Electromyography confirmed a right spinal accessory nerve lesion.Magnetic resonance imaging confirmed atlanto-occipital dislocation.Therefore, in survivors who are diagnosed with atlanto-occipital dislocation, any neurological symptoms should be carefully evaluated.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Medicine and Rehabilitation, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.

ABSTRACT
We report a patient with traumatic atlanto-occipital dislocation who presented with dysphagia as the chief complaint. A 59-year-old man complained of swallowing difficulty for 2 months after trauma to the neck. On physical examination, there was atrophy of the right sternocleidomastoid and upper trapezius muscles, and the tongue was deviated to the right. In a videofluoroscopic swallowing study, penetration and aspiration were not seen, food residue remained in the right vallecula and pyriform sinus, and there was decreased motion of the soft palate, pharynx and larynx. Electromyography confirmed a right spinal accessory nerve lesion. Magnetic resonance imaging confirmed atlanto-occipital dislocation. Dysphagia in atlanto-occipital dislocation is induced by medullary compression and lower cranial nerve injury. Therefore, in survivors who are diagnosed with atlanto-occipital dislocation, any neurological symptoms should be carefully evaluated.

No MeSH data available.


Related in: MedlinePlus