Renault F, Couvreur J, Ostre C, Tournier G
Laboratoire de Neurophysiologie Clinique de l'Enfant, Hôpital Armand-Trousseau, Paris.
Ann Pediatr (Paris). 1992 Jun;39(6):347-50.
In two infants with recurrent lower respiratory tract infections starting within a few weeks of birth, dynamic electromyographic studies of sucking and swallowing evidenced a disorder of lingual and pharyngeal activities responsible for the episodes of aspiration. The central location of the anomaly was demonstrated by the absence of peripheral neuromuscular anomalies and by the presence of impaired blinking reflexes and brain stem potential anomalies. These neurofunctional anomalies improved over time and magnetic resonance imaging failed to disclose and structural anomalies of the central nervous system. The occurrence of the swallowing disorder as an isolated manifestation and its long duration, with follow-ups of 23 months and 4 years, are two unique features in these cases. Neurophysiologic investigations are essential for documenting the neurologic etiology of the swallowing disorders, demonstrating their location above or within the medulla oblongata, and differentiating functional and organic anomalies.
在两名出生后几周内就开始反复出现下呼吸道感染的婴儿中，对吸吮和吞咽进行的动态肌电图研究表明，舌部和咽部活动紊乱是导致误吸发作的原因。由于不存在周围神经肌肉异常，且存在眨眼反射受损和脑干电位异常，因此证明了该异常位于中枢。这些神经功能异常随时间推移有所改善，磁共振成像未发现中枢神经系统的结构异常。吞咽障碍作为一种孤立表现出现且持续时间长，随访时间分别为23个月和4年，是这些病例的两个独特特征。神经生理学检查对于记录吞咽障碍的神经病因、证明其位于延髓上方或延髓内以及区分功能性和器质性异常至关重要。
