Respiratory Dysfunction in Advanced Multiple Sclerosis

What respiratory problems are common in advanced MS?
A common symptom of MS is muscle weakness which may affect the muscles that control breathing. Muscle weakness can make breathing difficult and shallow breathing may contribute to pneumonia. Muscle weakness can also affect swallowing which may lead to aspiration pneumonia. It’s important to remember that patients with MS may have difficulty fighting infection caused by bacteria or viruses.

What are early signs of respiratory muscle weakness?
Symptoms may be subtle such as shortness of breath or a gradual increase in coughing when the person with advanced MS eats or drinks fluids. Increased coughing or total obstruction of the airway may occur when eating solids. Medications that cause drowsiness may affect a person’s ability to control swallowing as well. Or symptoms might emerge when the muscles that control breathing are under increased pressure, such as when you may be standing in chest-high water.

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Living with Advanced MS: Respiratory Care

Can RA Cause Changes in Your Voice?

According to a new literature review in the journal Autoimmune Diseases, the prevalence of laryngeal symptoms of RA has risen from up to 31% of RA patients in 1960 (Lawry, 1984) to 75% by the end of the 20th century (Hamdan, 2013).  At least a portion of this significant increase is likely due to increased awareness and better clinical diagnosis.

Symptoms of larynx involvement caused by RA include odynophagia (painful swallowing), foreign body sensation, dysphagia (difficulty swallowing), sore throat, lump sensation in the throat, change in voice quality (e.g. hoarseness, breathiness, vocal fatigue), referred otalgia (earache), and respiratory symptoms (e.g. shortness of breath, decreased exercise tolerance, stridor, dyspnea, respiratory distress). In rare cases, patients with RA may also present with symptoms of croup.  Patients may also be asymptomatic.

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Hoarseness and Shortness of Breath: Is Your RA the Cause?