Autoimmune Neurogenic Dysphagia

Autoimmune neurogenic dysphagia is a kind of dysphagia caused by autoimmune diseases that affect the muscle, neuromuscular junction, nerves, roots, brainstem, or cortex. Dysphagia can be a part of a rising clinical symptomatology of an underlying neurological autoimmunity, or it might be a solitary, acute or insidious manifestation. This article describes the autoimmune neurological causes of dysphagia, the clinical signs & symptoms, laboratory testing that can help with early diagnosis, especially when dysphagia is the presenting complaint, and the most effective immunotherapeutic therapies. Dysphagia is prevalent in inflammatory myopathies, particularly inclusion body myositis, and it also occurs often in myasthenia gravis, appearing early in bulbar-onset sickness or later in progressive, generalised disease. Acute dysphagia is common in Guillain-Barre syndrome variations, while slowly progressing dysphagia is common in paraneoplastic neuropathies with particular autoantibodies. The most common causes of CNS autoimmune dysphagia are demyelinating and inflammatory lesions in the brainstem, which occur in persons with multiple sclerosis and neuromyelitis optica spectrum disorders. Dysphagia in stiff-person syndrome, particularly in connection with cerebellar ataxia and strong anti-GAD autoantibodies, and gastrointestinal dysmotility syndromes due to autoantibodies against the ganglionic acetylcholine receptor, are less common yet can be overlooked. In the setting of many CNS autoimmunities, acute-onset or growing dysphagia is a potentially curable condition that needs heightened vigilance for timely diagnosis and immunotherapeutic treatment.