From the Neurorehabilitation Section, Department of Physical & Rehabilitation Medicine, School of Medicine, Inha University, Incheon City, South Korea.
Am J Phys Med Rehabil. 2014 Mar;93(3):267-71. doi: 10.1097/PHM.0b013e3182a92f2f.
A 74-yr-old man developed left hemiplegia because of a right middle cerebral artery territory infarction and also had clinical features of dysphagia and speech difficulty. At that time, he complained of neck pain, but the symptom was ignored because he had a nasogastric tube and had been diagnosed with a huge epiglottic cyst that had already shown several symptoms such as severe hoarseness and throat discomfort. A videofluoroscopic swallowing study was planned to find out the cause and the type of dysphagia. On the videofluoroscopic swallowing study, a foreign body was found at the hypopharynx. Surprisingly, it was confirmed as a denture. After removing the denture, the patient's swallowing and speech difficulty were significantly improved. This case emphasizes the need for elderly stoke patients presenting with dysphagia or communication problems to receive more careful history taking and a more complete physical examination, with the cooperation of several clinical departments.
一位 74 岁男性因右侧大脑中动脉区域梗死导致左侧偏瘫,同时伴有吞咽困难和言语障碍等临床症状。当时他主诉颈部疼痛,但由于已插入鼻胃管且被诊断出患有巨大会厌囊肿,因此该症状被忽略了,该病已经出现严重声音嘶哑和咽喉不适等多种症状。计划进行视频透视吞咽研究以找出吞咽困难的原因和类型。在视频透视吞咽研究中,在下咽处发现了一个异物。令人惊讶的是,它被确认为假牙。取出假牙后,患者的吞咽和言语困难明显改善。该病例强调,对于出现吞咽困难或沟通问题的老年中风患者,需要更仔细地询问病史并进行更全面的身体检查,并与多个临床科室合作。