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Neurogenic dysphagia

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https://www.readbyqxmd.com/read/28635876/-salivation-after-stroke
#1
Z A Zalyalova
Salivation after stroke (sialorrhea, hypersalivation, ptyalism) can be caused by the overproduction or a lack of utilization of saliva. Patients after stroke often have sialorrhea as a result of dysphagia. Neurogenic dysphagia in acute period after stroke occurs in 25-65% of patients. The mortality rate among people with post-stroke dysphagia and tube feeding ranges from 20 to 24%. Patients who suffering from profuse salivation have difficulties with articulation and swallowing, bad breath, irritation and maceration of perioral area, contamination of clothing and bed linen...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28550869/achalasia
#2
Saleem Islam
Achalasia is a rare neurogenic motility disorder of the esophagus, occurring in approximately 0.11 cases per 100,000 children. The combination of problems (aperistalsis, hypertensive lower esophageal sphincter (LES), and lack of receptive LES relaxation) results in patients having symptoms of progressive dysphagia, weight loss, and regurgitation. Treatment modalities have evolved over the past few decades from balloon dilation and botulinum toxin injection to laparoscopic Heller myotomy and endoscopic myotomy...
April 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28528063/an-involuntary-and-unexpected-treatment-of-nutcracker-esophagus
#3
Diane Mege, Alban Benezech, Henri de Lesquen, Véronique Vitton, Pascal-Alexandre Thomas
A 76-year-old woman complained of painful dysphagia and loss of weight. Esophagoscopy results were negative, whereas computed tomography (CT) disclosed a 25-mm mediastinal tumor without a connection to the esophagus. A diagnosis of nutcracker esophagus was made on high-resolution esophageal manometry. Peroral endoscopic esophageal myotomy failed to improve the symptoms. Right video thoracoscopy allowed resection of the tumor, which looked like a neurogenic tumor of the posterior mediastinum that developed from the right vagus nerve...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28484823/-prolonged-weaning-during-early-neurological-and-neurosurgical-rehabilitation-s2k-guideline-published-by-the-weaning-committee-of-the-german-neurorehabilitation-society-dgnr
#4
REVIEW
J D Rollnik, J Adolphsen, J Bauer, M Bertram, J Brocke, C Dohmen, E Donauer, M Hartwich, M D Heidler, V Huge, S Klarmann, S Lorenzl, M Lück, M Mertl-Rötzer, T Mokrusch, D A Nowak, T Platz, L Riechmann, F Schlachetzki, A von Helden, C W Wallesch, D Zergiebel, M Pohl
Prolonged weaning of patients with neurological or neurosurgery disorders is associated with specific characteristics, which are taken into account by the German Society for Neurorehabilitation (DGNR) in its own guideline. The current S2k guideline of the German Society for Pneumology and Respiratory Medicine is referred to explicitly with regard to definitions (e.g., weaning and weaning failure), weaning categories, pathophysiology of weaning failure, and general weaning strategies. In early neurological and neurosurgery rehabilitation, patients with central of respiratory regulation disturbances (e...
May 8, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28416844/clinical-characteristics-of-neurogenic-dysphagia-in-adult-patients-with-chiari-malformation-type-i
#5
T Yu, J Li, K Wang, Y Ge, A C Jiang, L P Duan, Z Y Wang
OBJECTIVE: To investigate changes of swallowing function and associated symptoms in Chiari malformation typeI (CMI) patients with and without dysphagia by the analysis of their clinical and high-resolution manometry (HRM) parameters. METHODS: A total of 42 patients diagnosed with symptomatic CMI without atlantoaxial dislocations which were confirmed by clinical manifestations and magnetic resonance imaging (MRI) findings between January 2010 and July 2015 at Peking University Third Hospital were included in this study...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28412164/diagnosis-and-management-of-oropharyngeal-dysphagia-among-older-persons-state-of-the-art
#6
REVIEW
Omar Ortega, Alberto Martín, Pere Clavé
Oropharyngeal dysphagia (OD) is a condition recognized by the World Health Organization and defined as the difficulty or inability to move a bolus safely and effectively from the oral cavity to the esophagus, and can include aspirations, choking, and residue. OD is pandemic among different phenotypes of older people, affecting between 27% and 91% of the population 70 years or older. Although OD can be diagnosed by well-defined clinical methods and complementary explorations, in the clinical setting OD is seldom systematically screened and treated, and awareness among the medical/geriatric community is scarce...
April 12, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28400488/predictors-of-dysphagia-in-acute-pontine-infarction
#7
Sriramya Lapa, Sebastian Luger, Waltraud Pfeilschifter, Christian Henke, Marlies Wagner, Christian Foerch
BACKGROUND AND PURPOSE: Little is known about the frequency and the clinical characteristics of neurogenic dysphagia in pontine strokes. In this study, we sought to identify predictors for dysphagia in a cohort of patients with isolated pontine infarctions. METHODS: We included all patients admitted to our department between 2008 and 2014 having an acute (<48 hours after symptom onset) ischemic stroke in the pons, as documented by means of diffusion-weighted magnetic resonance imaging...
May 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28353151/the-use-of-brain-stimulation-in-dysphagia-management
#8
REVIEW
Andre Simons, Shaheen Hamdy
Dysphagia is common sequela of brain injury with as many as 50% of patients suffering from dysphagia following stroke. Currently, the majority of guidelines for clinical practice in the management of dysphagia focus on the prevention of complications while any natural recovery takes place. Recently, however, non-invasive brain stimulation (NIBS) techniques like transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have started to attract attention and are applied to investigate both the physiology of swallowing and influences on dysphagia...
April 2017: Dysphagia
https://www.readbyqxmd.com/read/28275351/botulinum-toxin-is-effective-in-the-management-of-neurogenic-dysphagia-clinical-electrophysiological-findings-and-tips-on-safety-in-different-neurological-disorders
#9
Enrico Alfonsi, Domenico A Restivo, Giuseppe Cosentino, Roberto De Icco, Giulia Bertino, Antonio Schindler, Massimiliano Todisco, Mauro Fresia, Andrea Cortese, Paolo Prunetti, Matteo C Ramusino, Arrigo Moglia, Giorgio Sandrini, Cristina Tassorelli
Background and Aims: Neurogenic dysphagia linked to failed relaxation of the upper esophageal sphincter (UES) can be treated by injecting botulinum toxin (BTX) into the cricopharyngeal (CP) muscle. We compared the effects of this treatment in different neurological disorders with dysphagia, to evaluate its efficacy over time including the response to a second injection. Materials and Methods: Sixty-seven patients with neurogenic dysphagia associated with incomplete or absent opening of the UES (24 with brainstem or hemispheric stroke, 21 with parkinsonian syndromes, 12 with multiple sclerosis, and 10 with spastic-dystonic syndromes secondary to post-traumatic encephalopathy) were treated with the injection of IncobotulinumtoxinA (dose 15-20 U) into the CP muscle under electromyographic guidance...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28155280/poor-consistency-in-evaluating-south-african-adults-with-neurogenic-dysphagia
#10
Mckinley Andrews, Mershen Pillay
BACKGROUND: Speech-language therapists are specifically trained in clinically evaluating swallowing in adults with acute stroke. Incidence of dysphagia following acute stroke is high in South Africa, and health implications can be fatal, making optimal management of this patient population crucial. However, despite training and guidelines for best practice in clinically evaluating swallowing in adults with acute stroke, there are low levels of consistency in these practice patterns. OBJECTIVE: The aim was to explore the clinical practice activities of speech-language therapists in the clinical evaluation of swallowing in adults with acute stroke...
January 23, 2017: South African Journal of Communication Disorders. die Suid-Afrikaanse Tydskrif Vir Kommunikasieafwykings
https://www.readbyqxmd.com/read/28029397/matrin-3-variants-are-frequent-in-italian-als-patients
#11
Giuseppe Marangi, Serena Lattante, Paolo Niccolò Doronzio, Amelia Conte, Giorgio Tasca, Mauro Monforte, Agata Katia Patanella, Giulia Bisogni, Emiliana Meleo, Salvatore La Spada, Marcella Zollino, Mario Sabatelli
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized by loss of motor neurons in the primary motor cortex, brainstem, and spinal cord. Recently, missense variants in MATR3 were identified in familial and sporadic ALS patients, but very few additional ALS patients have been reported so far. The p.S85C MATR3 variant was previously associated to a different phenotype, namely a distal myopathy associated with dysphagia and dysphonia. Here, we assessed the contribution of MATR3 variants in a cohort of 322 Italian ALS patients...
October 6, 2016: Neurobiology of Aging
https://www.readbyqxmd.com/read/27995067/brain-imaging-correlates-of-recovered-swallowing-after-dysphagic-stroke-a-fmri-and-dwi-study
#12
Paul Glad Mihai, Mareile Otto, Martin Domin, Thomas Platz, Shaheen Hamdy, Martin Lotze
Neurogenic dysphagia frequently occurs after stroke and deglutitive aspiration is one of the main reasons for subacute death after stroke. Although promising therapeutic interventions for neurogenic dysphagia are being developed, the functional neuroanatomy of recovered swallowing in this population remains uncertain. Here, we investigated 18 patients post-stroke who recovered from dysphagia using an event related functional magnetic resonance imaging (fMRI) study of swallowing. Patients were characterized by initial dysphagia score (mild to severe), lesion mapping, white matter fractional anisotropy (FA) of the pyramidal tracts, and swallowing performance measurement during fMRI scanning...
2016: NeuroImage: Clinical
https://www.readbyqxmd.com/read/27900347/isolated-dysphagia-as-initial-sign-of-anti-iglon5-syndrome
#13
Jens Burchard Schröder, Nico Melzer, Tobias Ruck, Anna Heidbreder, Ilka Kleffner, Ralf Dittrich, Paul Muhle, Tobias Warnecke, Rainer Dziewas
OBJECTIVE: To report on dysphagia as initial sign in a case of anti-IgLON5 syndrome and provide an overview of the current literature. METHODS: The diagnostic workup included cerebral MRI, fiber optic endoscopic evaluation of swallowing (FEES) with the FEES tensilon test, a videofluoroscopic swallowing study, evoked potentials and peripheral nerve conduction studies, polysomnography, lumbar puncture, and screening for neural autoantibodies. A systematic review of all published cases of IgLON5 syndrome is provided...
January 2017: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/27807279/design-and-implementation-of-pharyngeal-electrical-stimulation-for-early-de-cannulation-in-tracheotomized-phast-trac-stroke-patients-with-neurogenic-dysphagia-a-prospective-randomized-single-blinded-interventional-study
#14
Rainer Dziewas, Satish Mistry, Shaheen Hamdy, Jens Minnerup, Ingeborg Van Der Tweel, Wolf Schäbitz, Philip M Bath
Rationale Ongoing dysphagia in stroke patients weaned from mechanical ventilation often requires long-term tracheotomy to protect the airway from aspiration. In a recently reported single-centre pilot study, a significantly larger proportion (75%) of tracheotomized dysphagic stroke patients regained sufficient control of airway management allowing tracheotomy tube removal (decannulation) 24-72 h after pharyngeal electrical stimulation (PES) compared to controls who received standard therapy over the same time period (20%)...
June 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27757479/-diagnosis-and-treatment-of-parapharyngeal-space-tumors
#15
REVIEW
F Bootz, S Greschus, T van Bremen
The parapharyngeal space extends from the nasopharynx to the oropharynx. It is bordered medially by the pharyngeal wall and the constrictor pharyngis muscles, and laterally by the mandible. One distinguishes between a pre- and a poststyloid space. Tumors of the parapharyngeal space are rare and represent less than 1 % of all head and neck neoplasms. Benign (70-80 %) as well as malignant (20-30 %) tumors arise from different structures of the parapharyngeal space, mainly from salivary glands and nerve structures...
November 2016: HNO
https://www.readbyqxmd.com/read/27693396/functional-connectivity-patterns-of-normal-human-swallowing-difference-among-various-viscosity-swallows-in-normal-and-chin-tuck-head-positions
#16
Iva Jestrović, James L Coyle, Subashan Perera, Ervin Sejdić
Consuming thicker fluids and swallowing in the chin-tuck position has been shown to be advantageous for some patients with neurogenic dysphagia who aspirate due to various causes. The anatomical changes caused by these therapeutic techniques are well known, but it is unclear whether these changes alter the cerebral processing of swallow-related sensorimotor activity. We sought to investigate the effect of increased fluid viscosity and chin-down posture during swallowing on brain networks. 55 healthy adults performed water, nectar-thick, and honey thick liquid swallows in the neutral and chin-tuck positions while EEG signals were recorded...
December 1, 2016: Brain Research
https://www.readbyqxmd.com/read/27648173/validation-of-the-persian-version-of-the-dysphagia-handicap-index-in-patients-with-neurological-disorders
#17
Ebrahim Barzegar-Bafrooei, Jalal Bakhtiary, Ahmad Reza Khatoonabadi, Farzad Fatehi, Saman Maroufizadeh, Mojtaba Fathali
BACKGROUND: Dysphagia as a common condition affecting many aspects of the patient's life. The Dysphagia Handicap Index (DHI) is a reliable self-reported questionnaire developed specifically to measure the impact of dysphagia on the patient's quality of life. The aim of this study was to translate the questionnaire to Persian and to measure its validity and reliability in patients with neurogenic oropharyngeal dysphagia. METHODS: A formal forward-backward translation of DHI was performed based on the guidelines for the cross-cultural adaptation of self-report measures...
July 6, 2016: Iranian Journal of Neurology
https://www.readbyqxmd.com/read/27552353/occlusion-of-tracheostomy-tubes-does-not-alter-pharyngeal-phase-kinematics-but-reduces-penetration-by-enhancing-pharyngeal-clearance-a-prospective-study-in-patients-with-neurogenic-dysphagia
#18
Christian Ledl, Ylva Yasmin Ullrich
OBJECTIVE: Tracheostomy tubes (TT) are often needed in patients with severe neurologic injuries to protect the respiratory system from aspiration. However, TTs alter physiological oral-nasal airflow and are suspected to influence the pattern of pharyngeal swallowing. The aim of this work was to evaluate the effect of TT occlusion on pharyngeal swallowing physiology and to determine penetration-aspiration (PA) values of open versus closed TTs in neurogenic dysphagia. DESIGN: Prospective controlled clinical study with 20 tracheotomized patients after unilateral hemispheric stroke...
April 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/27531205/-efficacy-of-early-neurological-and-neurosurgical-rehabilitation-evidence-based-treatment-outcome-and-prognostic-factors
#19
REVIEW
M Pohl, M Bertram
BACKGROUND: Early neurological and neurosurgical rehabilitation (ENNR) as a complex post-acute form of treatment for patients with severe neurological diseases and continued need for intensive care is well established in Germany. OBJECTIVE: To assess the efficacy of ENNR from the perspective of evidence-based medicine as well as to present data on the outcome of ENNR patients including the analysis of prognostic factors. MATERIAL AND METHODS: A search was carried out in PubMed databases to identify early rehabilitation treatment forms evaluated by randomized controlled trials and with respect to large multicenter surveys of outcome and prognostic factors...
October 2016: Der Nervenarzt
https://www.readbyqxmd.com/read/27384435/outcome-of-rehabilitation-and-swallowing-therapy-after-percutaneous-endoscopic-gastrostomy-in-dysphagia-patients
#20
Ezekiel Wong Toh Yoon, Jun Hirao, Naoko Minoda
The objective of this study was to investigate the outcomes of rehabilitation (with swallowing therapy) after percutaneous endoscopic gastrostomy (PEG) in patients with neurogenic dysphagia. Forty-seven patients (29 males and 18 females) who were transferred to the rehabilitation ward of our hospital after receiving PEG tube placements during a 5-year period were enrolled in this study. Patients' demographic data, comorbidities, nutritional statuses, and laboratory biomarkers before the PEG procedure were collected...
December 2016: Dysphagia
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