A Rare Syndrome Causing Neurogenic Dysphagia

Excerpt

A 46-year-old right-handed man with a medical history of refractory stage IIIB, ALK-negative, anaplastic large-cell lymphoma came to our attention. He had previously been treated with several chemotherapy drugs, including brentuximab vedotin. Two weeks after completing salvage chemotherapy, the patient presented with progressive swallowing and speech difficulties. At this stage, he was admitted to our hospital for further diagnostic work-up and clinical management. Neurological examination showed severe dysarthria and bilateral weakness of facial, oromandibular and palatal voluntary movements. The patient could barely open his mouth and protrude his tongue on command. However, reflex movements (e.g., blink and gag reflexes) and activation of emotional and automatic motor responses (e.g., facial response to painful stimulus, laughing at jokes, mouth opening during yawning) were broadly spared. …