Langmore Susan E, Olney Richard K, Lomen-Hoerth Catherine, Miller Bruce L
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, 94115, USA.
Arch Neurol. 2007 Jan;64(1):58-62. doi: 10.1001/archneur.64.1.58.
Hyperorality, compulsive eating and aspiration because of food gorging, has been described in patients with frontotemporal lobar dementia (FTLD), but swallowing function in this population has not been reported.
To identify the swallowing status in a sample of patients with FTLD.
Case series.
Referral center, ambulatory care.
A consecutive series of referred patients with 3 variants of FTLD were asked to participate. Twenty-one patients were enrolled, including 9 with frontotemporal dementia, 7 with progressive nonfluent aphasia, and 5 with semantic dementia.
The patients underwent a fiberoptic endoscopic examination of swallowing to assess their ability to swallow liquids and food.
Presence of dysphagia and nature of impaired swallowing.
Of the 21 patients, 4 caretakers reported swallowing difficulties. An instrumental examination revealed moderate swallowing abnormalities in 12 of the 21 patients. These abnormalities were not explained by compulsive eating behaviors, but seemed to reflect deficits in cortical and subcortical pathways connecting with the brainstem swallowing center.
When assessed via instrumentation, swallowing abnormalities are found in many patients with FTLD. The appearance of dysphagia signals progression of FTLD to brainstem systems.
额颞叶痴呆（FTLD）患者存在口欲亢进、强迫进食以及因食物吞咽过多导致的误吸现象，但该人群的吞咽功能尚未见报道。
确定FTLD患者样本的吞咽状况。
病例系列研究。
门诊转诊中心。
连续纳入一系列被转诊的3种FTLD变异型患者。共纳入21例患者，其中9例为额颞叶痴呆，7例为进行性非流利性失语，5例为语义性痴呆。
患者接受吞咽功能的纤维内镜检查，以评估其吞咽液体和食物的能力。
吞咽困难的存在情况及吞咽障碍的性质。
21例患者中，4名照料者报告存在吞咽困难。仪器检查显示，21例患者中有12例存在中度吞咽异常。这些异常并非由强迫进食行为所致，而是似乎反映了与脑干吞咽中枢相连的皮质和皮质下通路的缺陷。
通过仪器评估发现，许多FTLD患者存在吞咽异常。吞咽困难的出现预示着FTLD已进展至脑干系统。
