Management Protocol for Mixed Dysarthria with Dysphagia Secondary to Multiple System Atrophy with Reference to Palliative Care Perspective: A Case Study

Abstract

Introduction: Multiple system atrophy (MSA) is a progressive, fatal disorder that makes muscles stiff (rigid) and causes problems with movement, loss of co-ordination, and malfunction of internal body processes such as blood pressure and bladder control. The Palliative care is an interdisciplinary approach to care for people with chronic disease/disorder or end-of-life conditions. The study was aimed to provide a documentation of a case with mixed dysarthria secondary to multiple system atrophy and to provide palliative care perspective of the case with reference to Speech Language Pathology. Methods: A Patient of 63 years/Male had the complaint of speech problem, difficulty in swallowing and movement problem. He was already diagnosed with MSA. In the diagnostic department, after all the assessment, the patient was diagnosed as mixed dysarthria with moderate pharyngeal dysphagia secondary to multiple system atrophy and referred for speech and swallowing therapy. Speech therapy was carried out in a palliative care domain within the patient’s limit of participation. After 7 sessions the patient couldn’t be able to continue therapy as the patient was admitted in ICU under medical condition. Discussion: In this MSA patient even after continuous 7 sessions of therapy, no such significant improvement observed although no such deterioration. And that was the main reflection of the goal oriented therapy techniques, that patient’s condition was not fall drastically as it was before. Conclusion: When an SLP is brought into work with a patient nearing end of life, swallowing and communication should be the main concern.