Approach to dysarthria or dysphagia Quiz: Ace Your Exams
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A 41-year-old woman presents to a primary care clinic for evaluation of difficulty swallowing. The patient has noticed persistent, non-progressive choking with swallowing and difficulty chewing food for two weeks. The patient’s partner has noticed her drooling. Past medical history includes multiple sclerosis, which is managed with interferon beta-1a and baclofen. Temperature is 37.0°C (98.6°F), pulse is 80/min, respirations are 12/min, and blood pressure is 120/80 mmHg. On exam, the patient appears alert, with flattening of the bilateral nasolabial folds and inability to pucker lips tightly. Food particles are present in the pockets of the cheeks. Spasticity of the left leg is noted. Which of the following additional history or physical findings is most likely to be present?
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