Speech Therapy for Dysphagia and Myasthenia Gravis

Swallowing something we do unconsciously many times a day is actually a complex process involving multiple muscles and nerves working together in perfect harmony. But for some individuals, especially those recovering from illnesses like COVID-19 or living with conditions such as Myasthenia Gravis, swallowing can become a difficult, even painful, task. This condition is known as Dysphagia, and it can significantly impact a person’s health, nutrition, and overall quality of life.

This comprehensive blog explores Dysphagia in COVID-19 patients, the effects of Myasthenia Gravis on speech and swallowing, and practical tongue exercises that can help improve swallowing function.

Dysphagia in COVID-19 Patients: Understanding the Link

During the COVID-19 pandemic, many critically ill patients required Invasive Mechanical Ventilation (MV) or tracheostomy for respiratory support. While these interventions were life-saving, research shows that they can sometimes lead to pharyngeal muscle dysfunction, a key factor associated with Dysphagia.

Study Overview

A study conducted by Ceruti and team aimed to investigate the presence of Dysphagia in COVID-19 ICU patients, describing the characteristics of the swallowing disorders and identifying associated risk factors. The research involved 31 ICU patients admitted with COVID-related complications in 2020.

Assessment and Evaluation

To assess swallowing function, researchers used the Gugging Swallowing Screen (GUSS) — a standardized test designed to evaluate Dysphagia severity. Patients were evaluated daily until recovery, with Dysphagia scored as follows:

• 0–9: Severe Dysphagia

• 10–14: Moderate Dysphagia

• 15–19: Mild Dysphagia

• 20: No Dysphagia

Evaluations were performed at Day 0, Day 7, Day 14, Day 21, and Day 28 to monitor improvement.

Therapy and Speech-Language Pathology Role

Speech-Language Therapy (SLT) interventions focused on:

• Reducing oral and pharyngeal sensitivity deficits

• Improving the initiation of the swallowing reflex

• Strengthening glottic closure

• Enhancing laryngeal elevation motor skills

Therapy was performed consistently alongside medical management to facilitate safe swallowing and recovery.

Key Findings

Of the 31 patients studied:

• 25 were on Mechanical Ventilators

• 19 used Endotracheal Tubes

• 6 had Tracheostomies

Remarkably, 55% of these patients developed Dysphagia. The use of mechanical ventilators was linked with more severe swallowing difficulties. However, with timely and consistent Speech-Language Therapy, many patients showed significant improvement over a short recovery period.

This highlights the vital role of Speech-Language Pathologists (SLPs) in managing Dysphagia in post-COVID ICU survivors through multidisciplinary care.

Myasthenia Gravis and Its Impact on Speech, Voice, and Swallowing

Our bodies are remarkable systems of communication — not only between people but also between nerves and muscles. When this communication is disrupted, it can result in a condition called Myasthenia Gravis (MG), a chronic autoimmune neuromuscular disorder that causes weakness in voluntary muscles.

What Happens in Myasthenia Gravis?

In healthy individuals, nerves send signals to muscles through receptor sites, similar to one player tossing a ball to another. In MG, antibodies attack these receptor sites, breaking this communication. As a result, muscles fail to receive proper signals, leading to weakness and fatigue especially after repetitive movements such as speaking or chewing.

Common Symptoms of Myasthenia Gravis

• Drooping eyelids (ptosis)

• Double vision

• Weakness in arms and legs

• Impaired speech

• Difficulty swallowing and chewing

• Facial weakness or inability to change expressions

The condition typically affects young women (20s–30s) and older men (60s–70s). Although MG has no cure, it is manageable through a combination of pharmacological and behavioral treatments.

Effects on Speech and Voice

People with MG may experience Dysphonia or Dysarthria, leading to noticeable voice changes such as:

• Vocal Fatigue – voice becomes weak after prolonged speaking

• Monotonous tone – difficulty changing pitch

• Short phrases – limited breath support

• Hoarseness or weak voice

• Slurred speech due to tongue and lip weakness

• Hypophonia – reduced loudness of speech

When these symptoms persist beyond two weeks, it is advisable to consult an ENT specialist or a Speech-Language Pathologist for diagnosis and therapy.

Swallowing Challenges in MG.

People with Myasthenia Gravis may face:

• Difficulty chewing towards the end of meals

• Choking or coughing during swallowing

• Extended meal times due to fatigue

• Aspiration risk, where food enters the airway

Since swallowing involves precise coordination of several muscles, MG can cause fluctuating Dysphagia symptoms that often improve with rest or medication.

Role of Speech-Language Therapy

Speech-Language Pathologists play an essential role in the rehabilitation of speech, voice, and swallowing for MG patients. Therapy focuses on:

• Strengthening affected muscles

• Teaching compensatory communication techniques (like gestures or writing)

• Scheduling speech or swallowing activities at the peak of medication effect

People living with MG often describe it as the “snowflake disease” because no two cases are alike. With proper therapy, medical support, and emotional encouragement, individuals with MG can lead fulfilling lives while effectively managing their symptoms.

The Power of Multidisciplinary Care in Dysphagia Management

From COVID-19 recovery to neuromuscular disorders like Myasthenia Gravis, swallowing difficulties can arise due to multiple causes. Early evaluation by Speech-Language Pathologists and tailored therapy programs can drastically improve recovery outcomes. In all cases, collaboration between medical professionals, therapists, and caregivers is crucial to support individuals toward safe eating, better nutrition, and improved quality of life.

Final Thoughts

Whether it’s through targeted therapy for post-COVID Dysphagia, managing muscle fatigue in Myasthenia Gravis, or playful tongue exercises for children, the journey toward better swallowing begins with awareness and proactive care. At 1SpecialPlace, expert Speech-Language Pathologists provide comprehensive Online Speech Therapy for Dysphagia, voice disorders, and swallowing rehabilitation, empowering individuals across all ages to reclaim their independence and confidence.