|Noninvasive ventilation can be delivered through a mask or
mouthpiece. Photo courtesy of Respironics.| In spinal-bulbar
muscular atrophy, swallowing and chewing muscle weakness pose a
choking hazard. A swallowing specialist should be consulted to
determine the safest ways of swallowing, and to learn ways to
alter food consistency. A feeding tube can be considered in
cases of extreme weakness. Weakness in the throat muscles also
can make breathing during sleep difficult. Noninvasive
ventilation aids such as a bilevel positive air pressure device
(such as BiPAP by Respironics), which pushes in air under
pressure, can help with this. As the disease progresses over
many years, a scooter or wheelchair may eventually be needed for
longer distances.