this is a panel about Laryngeal Dystonia – challenges and pitfalls in diagnostics and treatment

Description

In this short talk, I will focus on the diagnostic dilemma posed by patients who continue to experience dizziness despite successful canalith repositioning maneuvers for BPPV. Using selected patient cases and vestibular testing data, I will explore how residual dizziness can overlap with or mask underlying conditions such as vestibular migraine, Ménière’s disease, or persistent postural-perceptual dizziness (PPPD). My goal is to help clinicians differentiate between benign post-treatment symptoms and signs of a broader vestibular pathology that requires additional management.

Outcome Objectives

After this presentation, attendees will be able to:

• Recognize clinical red flags that suggest residual dizziness is not due to BPPV alone

• Compare features of RD with vestibular migraine, Ménière’s disease, and PPPD

• Apply practical strategies to avoid unnecessary repeated repositioning maneuvers

Outcome Objectives

By the end of this session, participants will be able to:

• Recognize swallowing dysfunction patterns in a range of systemic diseases.

• Analyze pathophysiological mechanisms linking systemic conditions to dysphagia.

• Interpret VFSS and FEES findings in systemic disease-related swallowing disorders.

• Compare therapeutic strategies for managing dysphagia in complex internal medicine patients.

• Implement interdisciplinary assessment approaches in their clinical practice.

Structure of the Session

• Brief overview of systemic diseases commonly associated with dysphagia

• Pathophysiological insights for each condition

• Case presentations with VFSS and FEES video analysis

• Interactive discussion on evaluation and management strategies

• Audience Q&A and takeaway clinical pearls

Background

Swallowing involves a complex neuromuscular coordination that can be disrupted by systemic diseases affecting the gastrointestinal, endocrine, connective tissue, or central nervous systems. Inflammatory bowel diseases can lead to pharyngeal dysmotility via systemic inflammation or medication effects. Fibromyalgia and amyloidosis may impair swallowing through myopathy or protein deposition in muscular and neural tissues. Hypothyroidism and Behçet’s disease can lead to structural or sensory abnormalities. Neurological diseases, whether central or peripheral, are well-known causes of oropharyngeal dysphagia. Despite their varied etiologies, these conditions often present with overlapping symptoms and require detailed instrumental evaluation for accurate diagnosis. VFSS and FEES are essential tools for identifying aspiration risk, residue, and impaired protective reflexes in this population.