Prevalence of Speech and Swallowing Dysfunction and Intervention Among Individuals With Myasthenia Gravis.

Objective: To examine the prevalence of dysphonia and dysphagia among individuals with myasthenia gravis (MG) and the frequency of utilization of speech and swallow evaluation and therapy.

Study design: Retrospective cohort study.

Setting: TriNetX US Collaborative Network.

Methods: The cohort includes adults (≥18 years) with and without MG diagnosis. Propensity score matching was used before generating odds ratios (OR) of receiving speech and swallow diagnoses including dysarthria, dysphonia, dysphagia, and aspiration pneumonia. Subsequently, rates of individuals with MG receiving voice and swallow evaluation and therapy were analyzed.

Results: In this cohort, the prevalence of voice, speech, and swallowing pathology was higher in those with MG than without, including aspiration pneumonia (3.7% vs 0.7%), dysarthria (9.2% vs 0.5%), dysphonia (4.4% vs 1.2%), and dysphagia (24.9% vs 4.7%). ORs for diagnosis of each type of pathology were higher after MG diagnosis, including for aspiration pneumonia (OR: 2.69 [95% confidence interval, CI: 1.95-3.70]), dysarthria (OR: 9.28 [95% CI: 6.67-12.92]), dysphonia (OR: 2.63 [95% CI: 1.97-3.53]), and dysphagia (OR: 4.18 [95% CI: 3.62-4.83]). Finally, the rate of receiving a swallow and/or voice evaluation and/or therapy was low among all individuals with MG (16.9%) but higher among those with MG with any speech or swallow symptom (47.0%), MG with dysarthria and/or dysphonia (56.2%), and MG with dysphagia and/or aspiration pneumonia (49.0%).

Conclusion: Rates of dysarthria, dysphonia, dysphagia, and aspiration pneumonia were far more common among those with MG than without, but formal speech and/or swallow evaluation was not routine. These findings suggest a need for more routine speech-language pathology evaluation among individuals with MG.