Patients with neurological diseases are often affected by impaired nutrition. Resulting consequences have a negative impact on morbidity and thus on the patients’ mortality. For this reason, implementing appropriate nutritional management is a matter of significant importance.1
Implications of malnutrition are numerous. Cognitive impairments but also difficulties in swallowing play an important role. Patients concerned with dysphagia caused, for example by neurological diseases like amyotrophic lateral sclerosis or dementia and stroke, are therefore exposed to a heightened risk – not least by an increased risk of infections, frequent hospital admissions and accelerated functional decline. For example, 2/3 of patients with strokes are affected by dysphagia and therefore are at a higher risk of mortality. In these cases, enteral tube feeding is able to compensate for impaired swallowing.2,3
Clinical summary: Presentation/Clinical history
Mr H, 57 years, physical activity teacher, current weight: 75.3 kg (BMI 24.0 kg/m2)
Diagnoses: motor neurone disease/amyotrophic lateral sclerosis, dysphagia, chest infections
PEG sited for feeding overnight
Weight loss total approx. 12.4% from onset of symptoms
Outcome: 8 weeks post discharge
Download the complete and detailed patient case here
Download the complete and detailed patient case here
Clinical summary: Presentation/Clinical history
Mr J, 37 years, satellite technician, current weight: 104.3 kg (BMI 34.9 kg/m2)
Diagnoses: severe skull, left tibia and left humorous fractures
Intracranial epidural haematoma diagnosed and surgery completed
A nasogastric tube in situ due to an induced coma and oral ventilation
Weight loss: 3.4 % – not significant
Outcome: 3 months post admission
Download the complete and detailed patient case here
Download the complete and detailed patient case here
Clinical summary: Presentation/Clinical history
Mrs K, 72 years, grandmother living with dementia, current weight: 61.1 kg (BMI 21.9 kg/m2)
Admitted to hospital for IV antibiotics for a recent severe chest infection
Nutritional screening: identified as high risk as she has lost 11.4 % of body weight in the past 6 months. Oral intake is minimal.
Outcome: 1 month post discharge
Download the complete and detailed patient case here
Download the complete and detailed patient case here
Clinical summary: Presentation/Clinical history
Mrs L, 63 years, retired nurse, current weight: 53 kg (BMI 22.1 kg/m2)
Admitted with sudden onset dysarthria and right-sided weakness
Diagnoses: left-sided ischaemic stroke, no oral intake
Enteral feeding commenced via nasogastric tube within 24 hours of admission
Outcome: 8 weeks post treatment
Download the complete and detailed patient case here
Download the complete and detailed patient case here
The following four example cases illustrate how different patients in the field of neurological diseases may benefit from tube feeding:
Fresubin tube feeding in neurological patients. What Fresubin can do for your patients.
Fresubin tube feeding in neurological patients. What Fresubin can do for your patients.
References:
1) Rosenfeld J, Ellis A. Nutrition and dietary supplements in motor neuron disease. Phys Med Rehabil Clin N Am. 2008;19(3):573–589.
2) Nunes G, Santos CA, Grunho M, Fonseca J. Enteral feeding through endoscopic gastrostomy in amyotrophic lateral sclerosis patients. Nutr Hosp. 2016;33(5):1015–1021.
3) Dionyssiotis Y, Papachristos A, Petropoulou K, Papathanasiou J, Papagelopoulos P. Nutritional Alterations Associated with Neurological and Neurosurgical Diseases. Open
Neurol J. 2016;10:32–41.
