Ann Rehabil Med.  2012 Jun;36(3):409-413. 10.5535/arm.2012.36.3.409.

Neuromuscular Electrical Stimulation Therapy for Dysphagia Caused by Wilson's Disease

• Lee SY
• Yang HE
• Yang HS
• Lee SH
• Jeung HW
• Park YO

• KMID: 2266749
• DOI: http://doi.org/10.5535/arm.2012.36.3.409

Abstract

Wilson's disease is an autosomal recessive disorder of abnormal copper metabolism. Although dysphagia is a common complaint of patients with Wilson's disease and pneumonia is an important cause of death in these patients, management of swallowing function has rarely been reported in the context of Wilson's disease. Hence, we report a case of Wilson's disease presenting with dysphagia. A 33-year-old man visited our hospital with a complaint of difficulty in swallowing, since about last 7 years and which had worsened since the last 2-3 months. He was diagnosed with Wilson's disease about 13 years ago. On the initial VFSS, reduced hyoid bone movement, impaired epiglottic movement and moderate amount of residue in the valleculae during the pharyngeal phase were noted. After 10 sessions of neuromuscular electrical stimulation for 1 hour per day, decreased amount of residue was observed in the valleculae during the pharyngeal phase on the follow-up VFSS.

Keyword

Hepatolenticular degeneration; Deglutition disorder; Electrical stimulation

MeSH Terms

Adult
Cause of Death
Copper
Deglutition
Deglutition Disorders
Electric Stimulation
Electric Stimulation Therapy
Follow-Up Studies
Hepatolenticular Degeneration
Humans
Hyoid Bone
Pneumonia
Copper

Figure

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  Fig. 1 Brain magnetic resonance imaging on fluid attenuated inversion recovery imaging shows high signal intensity (arrow) in the pons (A) and the midbrain (B).

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  Fig. 2 Videofluoroscopic swallowing study images were taken after swallowing bananas (A, C) and cookies (B, D). (A, B) the initial video fluoroscopic swallowing study demonstrates a moderate amount of residue in the valleculae (arrow). After 10 sessions of neuro muscular electrical stimulation, the follow-up VFSS was performed. (C, D) each examination shows a lesser amount of residue in the valleculae (arrow) compared with that in the previous test (B: banana, H: cookies).

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