Korean J Neurogastroenterol Motil.
2008 Dec;14(2):140-144.
A Case of Multiple System Atrophy Presenting with Esophageal Dysphagia
- Affiliations
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- 1Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. hyjung@amc.seoul.kr
Abstract
- Dysphagia occurs frequently as an accompanying sign of neurodegenerative disorders. Degeneration of the dorsal vagal motor nucleus may cause esophageal dysphagia. Multiple system atrophy (MSA) is a progressive neurodegenerative disorder of unknown etiology. Dysphagia is one well-recognized complication of MSA and is closely related to the prognosis of patients. However, the swallowing function of patients with MSA has not been explored systematically. We experienced a 73-year-old male who had recurrent syncope with dysphagia. Neurologic examinations revealed a cerebellar dysfunction and autonomic function tests were abnormal. We diagnosed this case as MSA. The esophagogastroscopy was normal and the esophageal manometry revealed low pressure of the upper esophageal sphincter and lack of normal peristalsis. Barium esophagography showed ineffective primary peristalsis and weak tertiary peristalsis. We considered that diagnosis of dysphagia caused by degeneration of autonomic cranial nerves.
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