Thursday, June 23, 2005

Report from the Neuro

I did post a little while ago about how I couldn't find the telephone number for the Neuro, because in amongst all my packing I'd managed to forget where I'd packed all the info on Michael. Anyway I did ring, and I did ask what had happened to the report, and was promised it would arrive as soon as possible, well it arrived, at the beginning of June, and I've been meaning to post something about it, but in amongst all the confusion that is life at the moment it just hasn't happened:

Results were as follows:

MR Brain Imaging:

There was some reduction in peritrigonal white matter bulk.

Bulbar EMG:

There was definite evidence on EMG that there has been reinnervation, and that therefore there is a bulbar palsy. The absence of the later components of the blink reflex is also evidence of a disturbance of the brain stem.

Discussion with Parents

Current investigations, particularly the bulbar EMG confirm there is an underlying neurological basis for Michael's feeding difficulties. He has evidence of a bulbar palsy on the electrical studies and this has affected his pharengyl stage of swallowing, leading to compromised swallow safety and risk of aspiration.

Although there may be some changes to his swallow function over time, generally when there is neurological disturbance of the messages from the brain stem to the muscles and the nerves controlling chewing and swallowing, we recognise that this is permanent, and therefore Michael will always have some degree of oromotor difficulty for feeding.

In terms of the scan findings, these are subtle changes and are often the pattern of change we see with prematurity. Sometimes we associate loss of white matter bulk or nerve tracts with motor or physical difficulties.

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