BOTTLE-FED INFANT WITH MYOTONIC DYSTROPHY: A CASE STUDY

Introduction Myotonic dystrophy (MD) is a neuromuscular disease and is characterized by myotonia in combination with progressive muscular dystrophy and multiple systemic complications. The main indicator of difficulties is often times dysphagia. The purpose of the study was to determine clinical features and temporal characteristics of swallowing in infants diagnosed with myotonic dystrophy. Methods The subject was a five-month-old infant with myotonic dystrophy. Bottle-feeding swallows of thin liquid were analyzed using videofluoroscopic swallow examination (VFSE) videos. The clinical features of swallowing included structural abnormalities, lip closure, sucking performance, aspiration and penetration, and bolus transition. The temporal characteristics were measured by the oral transit time, pharyngeal transit time, pharyngeal delay time, bolus appearance, and laryngeal vestibule closure. Results For clinical features of swallowing, the infant showed the weak control of tongue sucking, irregular rhythmic pattern of sucking, not properly tightened or closed lips, and silent aspiration and penetration. Results of temporal characteristics showed a longer duration time is required for temporal measurements of swallowing in cases of myotonic dystrophy. Conclusion We found that an infant with myotonic dystrophy suffers from swallowing difficulties. These difficulties can include poor sucking and lack of airway protection due to muscle weakness. Feeding and swallowing interventions are needed to aid in safe swallowing for an infant with myotonic dystrophy. It is critical to provide an adequate amount of nutrition and follow normal developmental milestones