Neurogenic dysphagia experiences/characteristics at a tertiary center-retrospective analysis

Abstract

Aims:To compare demographic and clinical features and their relation to rehabilitation outcomes in patients impaired swallowing after stroke or traumatic brain injury (TBI), anoxic brain injury, encephalitis and glioma.Methods:This retrospective study evaluated the medical records of patients with brain injury in our university rehabilitation. Patients who received swallowing therapy for 24 sessions (3 days a week for 8 weeks) were included. Swallowing was evaluated with a functional oral intake scale (FOIS) and videofluoroscopic swallowing study before and after rehabilitation. Videofluoroscopy images were scored using the Penetration Aspiration Scale (PAS). Functional status was assessed with the Functional Independence Measure.Results:The study included 271 patients [stroke: 175 (64.6%); TBI: 58 (21.4%); anoxic brain injury: 13 (4.8%); glioma: 18 (6.6%); and encephalitis 7 (2.6%)]. Significant improvement was observed on the FOIS in stroke (pretreatment: 5.9±1.9 vs. posttreatment: 6.1±1.9, p=0.011) and TBI groups (pretreatment: 5.3±2.4 vs. posttreatment: 5.9±7.0, p=0.007). In both groups, significant improvements were observed in all three consistencies (solid, pudding, and liquid) according to PAS after treatment (p<0.05). Stroke patients with the middle cerebral artery (MCA) and posterior cerebral artery syndromes showed statistically significant improvement on FOIS. Patients with the MCA syndrome also showed significant improvement in the liquid score of the PAS.Conclusions:Swallowing therapy was found effective in improving swallowing functions in patients with stroke and TBI. In particular, stroke patients with MCA involvement gained more benefit from treatment.

Keywords

• brain injury
• neurogenic dysphagia
• stroke
• vascular involvement
• swallow therapy
• rehabilitation