1. Sally Pittendrigh Speech Pathologist Optimal SP
Update in MND
ANCIG August 2015
Sally Pittendrigh Speech Pathologist Optimal SP
Optimal SP m

2. MND MDT Clinic MACQUARIE NEUROLOGY Operating since August 2011 MDT
Meets 1st and 3rd Wed every month
6 clients per clinic and cycle through clinic in 3 monthly epoque
MDT
Social Work/ Speech Path/Physio/OT/ Dietitian/Nursing/ Neurologist/ Orthoptist/ Resp Physician/MNDA rep/
Research Nurse/Genetic Counsellor.
RESEARCH
Bio Bank – hair/tissue/blood/urine with age matched controls (spouse/friend) and stored in Research Lab.
Research Lab - opened since 2013 and completing significant research.
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3. MND TREATMENT Medication
Rilutek – inhibits glutamate release
L Serin – amino acid
Potential new therapies emerging.
We also know that our patients lives better and longer with the input of 2 other variables (Traynor et al 2003 and Vandenberg et al 2005)
MDT
Institution of NIV
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4. Speech Pathology Swallowing Communication Secretion Management
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5. Swallowing “Non-compliant” with diet modifications
Behavioural features of Dysphagia
Time/fatigue/appetite/interest in food/ meal size
Weight change
Intervention
Texture / size / frequency plus some positional modifications
HEHP
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6. Speech
Dysarthria
Upper Motor Neuron (Spastic) – speech slow; laboured; imprecise articulation also impacts respiration and voice (harsh/strained quality)
Lower Motor Neuron (Flaccid) – hypernasal; breathiness of voice and imprecise articulation;
Mixed – common
There is no evidence that strength based training is beneficial
Compensatory strategies and energy conservation
Speech Pathology Intervention in MND
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7. Alternative Communication
Heavy technology focus
Speech Generating Device (SGD)
Voice Banking
Amplification
Eye Gaze
Low technology
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8. Secretion Management Oral and Pharyngeal Pharyngeal Secretion Mx
Usually Excessive
Runny versus thick and ropey
Pharyngeal Secretion Mx
Oral care and hydration
Dark grape juice
Saline humidifcation
Home suction
Oral secretion Mx
Oral hygiene and hydration
Anticholinergic meds
Botox (intraglandular)
Radiation Rx (short low dose)
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