LAUSR

A 67-year-old male with cervical dystonia presented to his neurologist with complaints of globus sensation and difficulty swallowing. His past medical history included essential hypertension, hypothyroid, cardiac arrest, and bilateral globus pallidus interna (GPi) deep brain stimulator (DBS) implantation. Neurology initiated work-up with a barium swallow study which showed silent aspiration. The patient was then referred to the speech-language pathologist (SLP). The SLP’s clinical examination revealed multiple swallows and globus sensation with all consistencies. Instrumental assessment using modified barium swallowing study (MBS) showed incomplete laryngeal elevation, absent pharyngeal contraction, severe pharyngeal retention, and no functional epiglottic movement. There was aspiration across consistencies trialed both during and after the swallow. The patient was seen for a course of swallowing therapy including exercises to target areas of dysfunction identified via MBS.