Terré R
Institut de Neurorehabilitació Guttmann-UAB, 08916 Badalona, España.
Rev Neurol. 2020 Jun 16;70(12):444-452. doi: 10.33588/rn.7012.2019447.
The prevalence of oropharyngeal dysphagia is high after a stroke. Clinically, it manifests as alterations affecting swallowing efficiency and safety, with the consequent morbidity and mortality associated with nutritional and respiratory alterations.
To carry out an updated review of the diagnostic and therapeutic aspects of oropharyngeal dysphagia after a stroke that can be applied in daily clinical practice, and of the non-invasive neurostimulation techniques.
The process of diagnosis and treatment of oropharyngeal dysphagia aims to screen, identify and diagnose patients at risk of dysphagia, and establish the dietary and therapeutic measures that ensure proper nutrition and hydration of patients under safe conditions. The diagnosis is based on the clinical examination of swallowing and on instrumental examinations such as videofluoroscopy and fibro-endoscopy. Therapeutic measures include compensatory and rehabilitative strategies (active manoeuvres, motor control exercises, neuromuscular electrostimulation and botulinum toxin treatment). Neurostimulation techniques include non-invasive central stimulation and intrapharyngeal electrical stimulation.
The prevalence of oropharyngeal dysphagia is high after a stroke. Diagnosis should include a clinical evaluation and an instrumental examination, and thus objectively indicate the treatment, which will include compensatory and restorative measures with which to reduce the associated morbidity and mortality.
脑卒中后口咽吞咽困难的患病率很高。临床上，它表现为影响吞咽效率和安全性的改变，以及随之而来的与营养和呼吸改变相关的发病率和死亡率。
对可应用于日常临床实践的脑卒中后口咽吞咽困难的诊断和治疗方面以及非侵入性神经刺激技术进行最新综述。
口咽吞咽困难的诊断和治疗过程旨在筛查、识别和诊断有吞咽困难风险的患者，并制定饮食和治疗措施，以确保患者在安全条件下获得适当的营养和水分。诊断基于吞咽临床检查以及诸如电视荧光吞咽造影和纤维内镜检查等器械检查。治疗措施包括代偿性和康复性策略（主动动作、运动控制练习、神经肌肉电刺激和肉毒杆菌毒素治疗）。神经刺激技术包括非侵入性中枢刺激和咽内电刺激。
脑卒中后口咽吞咽困难的患病率很高。诊断应包括临床评估和器械检查，从而客观地指明治疗方法，治疗将包括代偿性和恢复性措施，以降低相关的发病率和死亡率。
