Myasthenia Gravis Support Group
Myasthenia gravis (MG) is a neuromuscular disease leading to fluctuating muscle weakness and fatiguability. The hallmark of myasthenia gravis is muscle weakness that increases during periods of activity and improves after periods of rest. Although myasthenia gravis may affect any voluntary muscle, muscles that control eye and eyelid movement, facial expression, and...
Hello! I am wondering if any of you have had a barium swallow test? My results showed oral spillage. Is this the same as premature spillage? Thank you so much for any input.
Premature spillage is when some of the food or liquid to be swallowed escapes from the oral cavity (what we think of as the mouth) and reaches the pharnx before the swallow starts.
You would probably be aware of anything escaping through the lips, so most likely it means premature spillage.
I found a good description of this on this website:
http://www.radiographicceu.com/article23.html
Here is the relevant text. The webpage also shows a X-ray graphic.
"Normal swallowing depends upon intact anatomical structures as well as intact afferent and efferent nerve conduits, and the correct physiological function and coordination of numerous muscle groups and cranial nerves. The structures involved in swallowing are illustrated on the lateral views of the head and neck. The structures include the teeth or dentures, the lips and intra-oral mucosa, the hard and soft palates, the velum, and the tongue bladethese structures comprise the oropharynx. In addition, the tongue base, the pharynx, the epiglottis and intrinsic larynx, and the upper esophageal sphincter (UES) comprise the hypopharynx. Within the hypopharynx are two sets of pockets or recesses known as the valleculae (plural of vallecula)the pockets between the base of the tongue and the epiglottis and the pyriform sinuses, another pair of recesses that are adjacent laterally to the larynx and which in normal swallowing empty their contents into the UES as the swallow occurs. These recesses provide a convenient physiologic catch basin for any food or fluid that should accidentally enter the hypopharynx prematurely before the swallow reflex occurs, thus helping ensure the spilled material stays out of the airway. Such premature spillage occurs frequently in dysphagic patients but also occurs in normally healthy adults who might be eating rapidly in the context of doing another distracting activity. The same recesses do pose problems for dysphagic individuals because with incomplete swallows, there frequently is residual material remaining in the recesses after the swallow. This pooled residual material can then compromise the airway at any time up to and including the next, subsequent swallow. This occurs because the airway is open for the exchange of oxygen more than 95% of time, except for the actual times that we swallow, phonate, or hold our breath.
I hope this helps. BTW I find that Mestinon helps with this problem as I find that during the spillage, you can aspirate a bit of the food and of course have a coughing fit to clear it out, thats just not fun though.
Joe
No I am currently being treated by GP. I went to a neurologist for initial diagnosis, he said you have MG, Take Mestonin 3x a day. See you in 4 months. He was the only Nuero with an appt. before mid April....Waiting for a Nuero appt. in another group...... Do you see a Nuero that specializes in MG?...There are only 3 in the area (in one group) and they are not accepting new patients. ....Luckily my Gener prac. is educated on MG and trying to help as much as possible until Nuero....Have CT Scan today.