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Re: #9 and #10 Cranial Nerve Damage/Throat Paralysis

Posted By CCF Neurology MD on February 20, 1998 at 19:17:03:

In Reply to: #9 and #10 Cranial Nerve Damage/Throat Paralysis posted by Cindy on February 13, 1998 at 09:28:49:







: My father is 65 years old and has a tracheotomy at this time. Thirty seven years ago he had a real high fever and was told he had encephalitis. Since then he had trouble swallowing and his speech changed. He had a lot of colds but never had to be hospitalized. In June 1997 he contracted pneumonia and had to have a trach put in at that time. He was in the hospital for a month. He has great difficulty swallowing and a lot of what he eats comes back out of his trach showing that he is trying to asyphiate his food. He is prone to get pneumonia again from asphyiating his food. So far we have been lucky. He has a lot of pooling of secretions that just sits in his throat (because his voice box won't move over) until he starts to choke and coughs it up. We checked into getting his throat stretched(diliation) but the doctors say that his throat is open but he can't make things go down the right way because everything is paralyzed from the nerve damage. They suggest a stomach bag for his food but he still has all these secretions that choke him. He is working but always worn out. He might have post polio syndrome that has made everything that has worked all of these years too worn out now. Is there anything that can be done to compensate for this nerve and paralysis damage? I don't have my own e-mail so I will just keep checking to see if there is any response. If there is a doctor that posts their e-mail, I can send them by e-mail all the letters from the doctors in more technical terms. Thanks
=Dear Cindy, Post-polio syndrome is the result of natural aging and death of the surviving neurons in those areas of the body initially affected by the polio virus.  This will result in the permanent loss of function in those areas where the neurons were initially damaged.  However, the area affected in a post-polio patient is invariably one in which was also originally affected (For example, if you were weak in your right leg from polio, you then recovered, but now as you reach old age that weakness is reoccouring and not improving over time).  Therefore, if your father never had any symptons of polio initially with the exception of encephalitis, I would question the diagnosis of post-polio syndrome.  Based on the information you have supplied me, another concern would be that your father has a motor neuron disease known as "progressive bulbar palsy" which overtime, progresses to become Amyotrophic Lateral Sclerosis(ALS or Lou Gehrig Disease).
I would discuss with the physicians taking care of your father about these issues.  It may be beneficial for you to have a second opinion to reassure your family that the diagnosis and treatment your father is receiving is appropriate.  Such an evaluation can not be done by having someone review the records on your father.  It would be necessary for your father to be evaluated by a neurologist, preferably one who is familiar with  post-polio syndrome and ALS.  "This information is provided for general education purposes only. Please consult your physician for dieagnostic and treatment options of your specific medical condition."

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