Dysphagia in amyotrophic lateral sclerosis: Prevalence and clinical findings

G. Ruoppolo, I. Schettino, V. Frasca, E. Giacomelli, L. Prosperini, C. Cambieri, R. Roma, A. Greco, P. Mancini, M. De Vincentiis, V. Silani, M. Inghilleri

Research output: Contribution to journalArticlepeer-review


Objectives: To characterize swallowing deficits in amyotrophic lateral sclerosis (ALS); investigate the delay in dysphagia onset; estimate correlations between dysphagia severity and patients' functional status; identify the symptom(s) most likely to predict dysphagia. Materials and methods: A group of 49 consecutive patients with ALS, 14 with bulbar onset and 35 with spinal onset, underwent swallowing evaluation including bedside and fiberoptic endoscopic examination to detect dysphagia. Results: Patients with dysphagia were more likely than those without to have bulbar onset ALS (P = 0.02); more severely impaired chewing (P = 0.01); and tongue muscle deficits (P = 0.001). The only variable measured at first examination significantly associated with dysphagia was a more than mild tongue muscle deficit. The only variable useful in predicting dysphagia was a chewing deficit. In 10 of the 49 patients studied, swallowing evaluation disclosed an impaired cough reflex. Conclusions: Dysphagia in patients with ALS correlates significantly with bulbar onset and with oral swallowing impairment. Fiberoptic swallowing evaluation is a useful tool for detecting swallowing deficits and laryngeal sensitivity in patients with ALS. An impaired cough reflex is an unexpected finding in many patients with ALS.

Original languageEnglish
Pages (from-to)397-401
Number of pages5
JournalActa Neurologica Scandinavica
Issue number6
Publication statusPublished - Dec 2013


  • Amyotrophic lateral sclerosis
  • Cough reflex
  • Deglutition disorders
  • Dysphagia

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology


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