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April 1, 2020

Unusual Cause of Dysphagia in a Patient With Cervical Spondylosis.

by Editor-In-Chief

Chu ECP, Shum JSF, Lin AFC.

Clin Med Insights Case Rep. 2019 Dec 29;12:1179547619882707. doi: 10.1177/1179547619882707. eCollection 2019.

PMID:
31908560

Abstract

A variety of age-related problems, including salivary secretory disorders, poor oral motor coordination, neuromuscular weakness, neurodegenerative diseases, stroke, and structural changes, can result in swallowing disorders. Given that causes of dysphagia differ from patient to patient, individualized treatment plans tailored toward patients’ specific conditions are needed. Here we present a case of an elderly woman with upper neck stiffness and dysphagia sought chiropractic treatment. Radiographic findings suggested cervical spondylosis with a vertical atlantoaxial subluxation. Following 20 sessions of chiropractic treatment, the patient experienced complete relief from neck problems and difficulty in swallowing. Rhythmic swallowing movements are controlled by a central pattern-generating circuit of the brain stem. In this case, the brain stem could have been compressed by the odontoid process of the axis due to C1/2 instability. Cervicogenic dysphagia is a cervical cause of difficulty in swallowing. Cervical complaints in the context of dysphagia are mostly under-estimated. A high degree of clinical suspicion is pivotal in timely intervention.

 

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