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Thread: dysphagia in c4 transection

  1. #1

    Dyphagia in C4 AIS A

    there has been no swallowing in asia a c4 SCI in my uncle.
    please tell me what are his survival chances

    it has been 75 days
    dysphagia both to solids and liquids
    asia a c4 transection
    Last edited by SCI-Nurse; 03-15-2014 at 11:37 AM.

  2. #2
    he is unable to swallow, how was he injured? what is his breathing status?

    I need a little more information

    pbr

  3. #3
    he had RSA and whiplash injury,he is off ventilator,on tracheostomy
    today endoscopy revealed large haitus hernia and diffculty in negotating upper sphincter.
    injured at c4 ,fracture of c4 vertebrae.fixed at c3-c5 by anterior corpectomy.
    dysphagia to both liquids and solids.
    Lastly how much time would secretions continue.
    having lot of secretions.

  4. #4
    What are they saying is his level of spinal CORD damage and AIS class? Is he in a trauma center that is part of a large SCI rehabilitation center? Do they know how to do assisted cough? Copious secretions from the lungs may be due to pneumonia, or just being unable to cough due to paralysis. Use of a Cough Assist machine, chest PT, and lots of quad coughing are needed. We also use every 4 hour IPPB for these patients. He should also be getting diaphragm strengthening exercises since that is about all he has to breathe with.

    Is he being seen by a speech pathologist for his dysphagia? This may improve as swelling goes down from the anterior spinal surgery (which can compress the esophagas), but nerve damage can also cause this. Only time will tell. Meanwhile, he should be getting his nutrition and meds all by tube, and should have a PEG tube inserted for this.

    (KLD)

  5. #5
    His AIS class is A according to Indian spinal injury centre at New Delhi.They r managing assisted cough.He is been given physio by speech pathologist.
    He is getting food by P.E.G tube.Latest endoscopic reports reveal large haitus hernia and difficulty in negotatiang upper sphincter.
    He has lot of spasticity in arms continuing to hands.
    Grade 3 pressure ulcer at back.
    How much time do we suppose for swallowing disorder to continue.
    thanks

  6. #6
    Not possible to tell about swallow. For some it is permanent. A hiatal hernia does not cause dysphagia. It can cause GERD. Have you talked to the speech pathologist about what type of therapy they are doing for his swallowing? Is he a candidate for electrical nerve stimulation therapy?

    What kind of bed is he on and how is the pressure ulcer being treated?? Is it over his sacrum or higher on the spine? Is he in a specialty hospital or unit for people with SCI?

    (KLD)

  7. #7
    pressure ulcer is on sacrum .It is a speciality hospital dealing with spinal cord injury patients
    dont know about elctric nerve stimulation therapy
    It is dedicated rehab centre.

  8. #8
    He has lot of neuropthic pain in both arms
    what is best possible remedy for neuropathic pain

  9. #9
    Modalities that should be tried include TENS, guided imagry and relaxation training. Acupucture has been helpful for some.

    Medications used are most often are the antiseizuere drugs: gabapentin or pregabalin, sometimes Tegretol. These all have side effects that must be watched for and managed. A SCI trained physiatrist should know about neuropathic pain management. It is unlikely that any intervetions will make the pain go away completely. The goal we aim for is to get it to a tolerable level for the patient.

    (KLD)

  10. #10
    can we go stem cell therapy as there is very less motor recovery sice 84 days after injury.

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