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Trying hard

Respiratory Dystonia

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First off thank you for all that you do, it is deeply appreciated.


I am curious as to what effect respiratory dystonia would have on swallowing and speech in a late stage PD patient. 


Thank you


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Has the patient you described actually been diagnosed with "dystonia" or is this a situation where long-term effects of medication are affecting respiration?  The effect in either case would have an impact on both swallowing and speech but the treatment recommendations might vary.  The effects will vary by individual so it isn't possible to describe how a specific patient would be effected.  In general, respiratory dystonia could interfere with the timing of swallowing and respiration and possibly result in liquids or solids "going down the wrong way" - towards the airway instead of the esophagus.  This can pose a serious health risk with the potential for developing pneumonia or some type of respiratory infection.  The impact on speech could be just as devastating but not have the same potential health consequences as the impact on swallowing.  Voicing may be difficult resulting in a raspy or harsh or breathy voice quality and the length of a spoken sentence could be shortened.  There is also potential for reduced loudness.  I suggest this patient have an evaluation to determine whether there are treatment interventions for swallowing or speech that would be appropriate or whether there are adaptations to eating during meals that would be helpful to make eating safer and more efficient.


This sounds like a challenging time for this patient.  I hope this information is helpful.  Please write again if you have any further questions.




Dr. Mahler

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