Treatment of type I spinal muscular atrophy with noninvasive ventilation and gastrostomy feeding.

Abstract:

:Type I spinal muscular atrophy (SMA) is a rapidly progressive, degenerative neuromuscular disease of infancy. In severe SMA, weakness, hypotonia, and bulbar involvement lead to progressive respiratory insufficiency and swallowing dysfunction, which are frequently complicated by aspirations. There are few studies reported in the literature that address the respiratory management of type I SMA. This article reports the results of treating four patients with infantile SMA with noninvasive positive pressure ventilation and gastrostomy feeding. All patients had gastroesophageal reflux disease, which was managed medically. Despite these therapies, survival was only 1 to 3.5 months after presenting with severe aspirations. The treatment strategy, which can be effective in less rapidly progressive neuromuscular diseases, did not alter the very poor prognosis of type I SMA. The treatment options are reviewed, and a strategy designed to optimize quality of life for infants with this fatal disease is presented.

journal_name

Pediatr Neurol

journal_title

Pediatric neurology

authors

Birnkrant DJ,Pope JF,Martin JE,Repucci AH,Eiben RM

doi

10.1016/s0887-8994(97)00227-0

subject

Has Abstract

pub_date

1998-05-01 00:00:00

pages

407-10

issue

5

eissn

0887-8994

issn

1873-5150

pii

S0887899497002270

journal_volume

18

pub_type

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