Respiratory dysfunction in multiple sclerosis: a preliminary study of respiratory dysfunction in patients with motor disability
Mr Jonathan LEVYa, Dr Hélène PRIGENTb, Mrs Sandrine BUTELc, Prof Djamel BENSMAILa
a APHP - Hôpital Raymond Poincaré - Service de Médecine Physique et de Réadaptation, b APHP - Hôpital Raymond Poincaré - Service de Physiologie et Explorations Fonctionnelles Respiratoires / UMR1179 - INSERM - Université de Versailles Saint Quentin en Yvelines, c UMR 1179 – INSERM - Université de Versailles Saint Quentin en Yvelines
Introduction - Respiratory dysfunction is one of the main causes of morbidity during the course of multiple sclerosis (MS). We distinguish four main causes for respiratory dysfunction: respiratory muscles weakness, deglutition disorders, sleep disordered breathing, and control of breathing abnormalities.
Objective - The main purpose of this study was to describe the respiratory function of MS patients with motor disability.
Materials and methods - We conducted a prospective study in MS patients with a walking disability. The respiratory dysfunction was assessed with pulmonary function tests, using spirometric and plethysmographic measures. The motor respiratory dysfunction was assessed using the vital capacity (VC), in the sitting and upright positions. Maximum inspiratory and expiratory pressures were also measured. We also reviewed the history of associated deglutition and sleep disorders.
Results - Over a 2 year period, 81 patients were evaluated. The median EDSS was 8 (IQ 7-8.5), the mean duration of disease was 20 years ± 11.4 and mean time since loss of walking ability 6.9 years ± 5,3. The average vital capacity was 2.41L ± 1.08 i.e. 70,7 ± 0.3% of theoretical value. Fifty one patients (63%) had a significative decrease of VC (< 80%), being considered as severe (VC <50%) in 23 cases (28%).
Discussion - In patients with severe MS, respiratory dysfunction is frequent. Its diagnosis and a better knowledge of its complications could help physicians to provide more specific care.
 Tzelepis GE, McCool FD. Respiratory dysfunction in multiple sclerosis. Respir Med 2015. doi:10.1016/j.rmed.2015.01.018.
Keywords : multiple sclerosis; respiratory dysfunction; sleep disordered breathing; deglutition disorders; pulmonary function testing