Swallowing malfunction in patients with Huntington's disease - possibilities of therapeutic rehabilitation intervention
Abstract
Huntington's disease represents an autosomal dominant inherited neurodegenerative disease with infaust prognosis. The essence of the disease is that certain nerve cells in the brain (especially basal ganglia and cortex) become damaged and start to die gradually.
The disease may start in any age; however, most often Huntington's disease is manifested between 35 - 40 years of age. During 10 - 15 years of progression it leads to complete dependence of the patient on other people's care.
Even if it nowadays still remains an incurable fatal disease, the diseased may be helped significantly, e.g. by the possibilities of rehabilitation discussed in the contribution. The main aim is to affect manifestations and functional problems that are manifested in a special way in each patient.
Strong pathologic changes of Huntington's disease are apparent in motor activity, cognitive functions and behaviour. Less apparent, however, nor the less serious are the disorders of respiratory functions and of the orofacial area.
For physiological swallowing, a very sensitive neuromotor co-ordination in the area of the oral cavity, pharynx, larynx and oesophagus is fundamental. In case of Huntington's disease the co-ordination of phonation and respiration is a serious problem.
Respiratory problems, repeated infections of the upper respiratory tract, change of voice, mucous congestion, multiple swallowing of one mouthful, stagnation of food in the throat, increased salivation due to bad swallowing, coughing before swallowing, during and after swallowing are risk factors of dysphagia that may result in tachyphagia. The authors of the contribution show an example of two case histories and mention positive effects of physiotherapeutic intervention on swallowing disorders and as a result of it an improvement of the quality of life of the patients.