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Churg-Strauss Syndrome as an Unusual Cause of Dysphagia: Case Report.

Park J, Im S, Moon SJ, Park GY, Jang Y, Kim Y - Ann Rehabil Med (2015)

Bottom Line: Biopsy of the nasal cavity showed extravascular eosinophilic infiltration.All these findings suggested a rare form of Churg-Strauss syndrome involving multiple lower cranial nerves.Dysphagia improved after steroid therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea.

ABSTRACT
Systemic vasculitis is a rare disease, and the diagnosis is very difficult when patient shows atypical symptoms. We experienced an unusual case of dysphagia caused by Churg-Strauss syndrome with lower cranial nerve involvement. A 74-year-old man, with a past history of sinusitis, asthma, and hearing deficiency, was admitted to our department for evaluation of dysphagia. He also complained of recurrent bleeding of nasal cavities and esophagus. Brain magnetic resonance imaging did not show definite abnormality, and electrophysiologic findings were suggestive of mononeuritis multiplex. Dysphagia had not improved after conventional therapy. Biopsy of the nasal cavity showed extravascular eosinophilic infiltration. All these findings suggested a rare form of Churg-Strauss syndrome involving multiple lower cranial nerves. Dysphagia improved after steroid therapy.

No MeSH data available.


Related in: MedlinePlus

Results of videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES). (A) VFSS show gross silent aspiration with plain liquid. Vallecular and pyriform sinuses residues were observed. (B) FEES show a large amount of secretion in the laryngeal vestibules (A, arytenoid; PS, pyriform sinus; E, epiglottis; T, L-tube).
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Figure 3: Results of videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES). (A) VFSS show gross silent aspiration with plain liquid. Vallecular and pyriform sinuses residues were observed. (B) FEES show a large amount of secretion in the laryngeal vestibules (A, arytenoid; PS, pyriform sinus; E, epiglottis; T, L-tube).

Mentions: Videofluoroscopic swallowing study (VFSS) revealed delayed oral transit time with poor tongue palate contact, delayed pharyngeal trigger, and incomplete laryngeal elevation. Gross silent aspiration was observed with plain liquid with a penetration aspiration scale of 8. The patient had severe dysphagia with a functional oral intake scale of 1 (Fig. 3A). Fiberoptic endoscopic evaluation of swallowing (FEES) showed a large amount of secretion in the laryngeal vestibules, and laryngeal adductor reflex (LAR) to high air pressure stimulation to both arytenoid tissues was absent. Vocal cord mobility showed decreased motion in right side but no glottis gap was detected (Fig. 3B).


Churg-Strauss Syndrome as an Unusual Cause of Dysphagia: Case Report.

Park J, Im S, Moon SJ, Park GY, Jang Y, Kim Y - Ann Rehabil Med (2015)

Results of videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES). (A) VFSS show gross silent aspiration with plain liquid. Vallecular and pyriform sinuses residues were observed. (B) FEES show a large amount of secretion in the laryngeal vestibules (A, arytenoid; PS, pyriform sinus; E, epiglottis; T, L-tube).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496520&req=5

Figure 3: Results of videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES). (A) VFSS show gross silent aspiration with plain liquid. Vallecular and pyriform sinuses residues were observed. (B) FEES show a large amount of secretion in the laryngeal vestibules (A, arytenoid; PS, pyriform sinus; E, epiglottis; T, L-tube).
Mentions: Videofluoroscopic swallowing study (VFSS) revealed delayed oral transit time with poor tongue palate contact, delayed pharyngeal trigger, and incomplete laryngeal elevation. Gross silent aspiration was observed with plain liquid with a penetration aspiration scale of 8. The patient had severe dysphagia with a functional oral intake scale of 1 (Fig. 3A). Fiberoptic endoscopic evaluation of swallowing (FEES) showed a large amount of secretion in the laryngeal vestibules, and laryngeal adductor reflex (LAR) to high air pressure stimulation to both arytenoid tissues was absent. Vocal cord mobility showed decreased motion in right side but no glottis gap was detected (Fig. 3B).

Bottom Line: Biopsy of the nasal cavity showed extravascular eosinophilic infiltration.All these findings suggested a rare form of Churg-Strauss syndrome involving multiple lower cranial nerves.Dysphagia improved after steroid therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea.

ABSTRACT
Systemic vasculitis is a rare disease, and the diagnosis is very difficult when patient shows atypical symptoms. We experienced an unusual case of dysphagia caused by Churg-Strauss syndrome with lower cranial nerve involvement. A 74-year-old man, with a past history of sinusitis, asthma, and hearing deficiency, was admitted to our department for evaluation of dysphagia. He also complained of recurrent bleeding of nasal cavities and esophagus. Brain magnetic resonance imaging did not show definite abnormality, and electrophysiologic findings were suggestive of mononeuritis multiplex. Dysphagia had not improved after conventional therapy. Biopsy of the nasal cavity showed extravascular eosinophilic infiltration. All these findings suggested a rare form of Churg-Strauss syndrome involving multiple lower cranial nerves. Dysphagia improved after steroid therapy.

No MeSH data available.


Related in: MedlinePlus