Oropharyngeal and Esophageal Causes of Dysphagia - Differential Diagnosis
Oropharyngeal Dysphagia
• Neuromuscular causes: CVA/CNS tumor/ALS, Parkinson's, Myasthenia gravis/Lambert Eaton, Muscular dystrophy
• Structural causes:
- Intrinsic compression: Zenker's diverticulum, cervical ring/web/stricture, luminal malignancy
- Extrinsic compression: Head/Neck Malignancy, Anterior mediastinal mass (4 T's), Goiter
Esophageal Dysphagia
• Neuromuscular causes:
- Non-relaxation of EG junction: Achalasia, EG junction outflow obstruction
- Abnormal peristalsis: Absent Contractility, Ineffective Esophageal Motility, Fragmented Peristalsis, Esophageal Spasm, Hypercontractile Esophagus
- Systemic sclerosis
- Functional dysphagia
• Structural causes:
- Intrinsic compression: Schatzki Ring, Plummer-Vinson Web, Strictures from esophagitis (GERD, pills, eosinophils, infections), Luminal malignancy
- Extrinsic compression: Vascular ring, anterior mediastinal mass, enlarged aorta/heart
Dr. Anthony Xu @AnthonyXuMD
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