Abstract
Fifty patients with clinically probable or definite multiple sclerosis, 24 with and 26 without symptoms of dysphagia, underwent clinical evaluation by a neurologist, a speech/language pathologist, and a clinical dietician. On the same day, these patients underwent videofluoroscopic evaluation of swallowing substances of thin liquid, thick liquid, paste, and solid consistencies. The videofluoroscopic evaluation was performed and interpreted by a radiologist and a speech/language pathologist who were unaware of the patients' symptoms or clinical status. There was no significant difference in the videofluoroscopic results between patients with and without dysphagia. Fourteen of 50 subjects (28%) had either transient or persistent entry of barium into the larynx; seven of these subjects had dysphagia symptoms and seven did not. Clinical measures of disease severity, including the Scripps Neurological Rating Scale (p = 0.001), the Expanded Disability Status Scale (p = 0.002), and a quantified clinical rating score done by the speech/language pathologist (p = 0.020) all were significantly correlated with the blinded video-fluoroscopy results and are better predictors of radiologically demonstrable swallowing abnormalities than are symptoms of dysphagia in this population.