Speech-language Pathology Care of Patients with Myasthenia Gravis

Abstract

Myasthenia gravis is an autoimmune disease caused by the disruption of neuromuscular transmission, due to the production of antibodies against acetylcholine receptors located at the neuromuscular junction. The symptomatology of the disease is variable, mostly progressive, but not irreversible. With proper patient management, it is possible to achieve remission in most patients and to reduce the risk of complications such as malnutrition, dehydration and aspiration with aspiration pneumonia. Dominant bulbar symptoms include dysarthria, dysphonia and dysphagia. An important part is speech-language intervention. The most prominent symptoms in speech are fatigue of the orofacial muscles, hypernasality, and decreased volume of speech. In the oral phase, bolus formation and transport and nasal regurgitation are impaired. There is a high risk of silent aspiration in the pharyngeal phase. This fact emphasises the need for the instrumental diagnosis of swallowing deficits. Speech-language therapy for myasthenia gravis aims to alleviate

Keywords

• myasthenia gravis
• flaccid dysarthria
• oropharyngeal dysphagia
• dysphonia