Ann Rehabil Med.  2018 Feb;42(1):180-183. 10.5535/arm.2018.42.1.180.

Effectiveness of Combining Behavioral Treatment With Valproic Acid for Dysphagia Caused by Palatal Myoclonus in Patients With Stroke: Two Case Reports

• Kim BR
• Lee Y
• Kim SJ
• Kim H
• Lee JW
• Lee S
• Lee J

• KMID: 2440984
• DOI: http://doi.org/10.5535/arm.2018.42.1.180

Abstract

Palatal myoclonus (PM) is a rare disease that may induce dysphagia. Since dysphagia related to PM is unique and is characterized by myoclonic movements of the involved muscles, specific treatments are needed for rehabilitation. However, no study has investigated the treatment effectiveness for this condition. Therefore, the aim of this case report was to describe the benefit of combining behavioral treatment with valproic acid administration in patients with dysphagia triggered by PM. The two cases were treated with combined treatment. The outcomes evaluated by videofluoroscopic swallowing studies before and after the treatment showed significant decreases in myoclonic movements and improved swallowing function. We conclude that the combined treatment was effective against dysphagia related to PM.

Keyword

Deglutition disorders; Palatal myoclonus; Valproic acid; Behavioral therapy

MeSH Terms

Deglutition
Deglutition Disorders*
Humans
Muscles
Myoclonus*
Rare Diseases
Rehabilitation
Stroke*
Treatment Outcome
Valproic Acid*
Valproic Acid

Figure

• 

  Fig. 1 Brain magnetic resonance imaging and videofluoroscopic swallowing study (VFSS) findings of Case 1. (A) Hypertrophic olivary degeneration. (B) Initial VFSS: penetration of dysphagia diet level 3. (C) Follow-up VFSS: penetration of dysphagia diet level 5.

• 

  Fig. 2 Brain magnetic resonance imaging and videofluoroscopic swallowing study (VFSS) findings of Case 2. (A) Hypertrophic olivary degeneration. (B) Initial VFSS: aspiration of dysphagia diet level 2. (C) Follow-up VFSS: lack of penetration or aspiration of dysphagia diet level 5.

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