Section of Gastroenterology, Temple University Hospital, Philadelphia, Pennsylvania.
Department of Internal Medicine, Temple University Hospital, Philadelphia, Pennsylvania.
Semin Neurol. 2023 Aug;43(4):530-539. doi: 10.1055/s-0043-1771458. Epub 2023 Aug 14.
Dysphagia is a common symptom in many neurologic disorders. Patients with oropharyngeal dysphagia present with difficulties when they start to swallow, often with coughing and choking; whereas patients with esophageal dysphagia describe the feeling that swallowed food stops in the chest. Chronic neurologic diseases such stroke, Parkinson's disease, or dementia often have dysphagia as a symptom, particularly oropharyngeal dysphagia, and the term "neurogenic dysphagia" is often used. A disruption of the sophisticated, integrated sensorimotor swallowing system is usually the main reason behind dysphagia. Dysphagia can be associated with aspiration leading to aspiration pneumonia, and chronic dysphagia can lead to weight loss and malnutrition. Patients with dysphagia, when accurately and promptly diagnosed through medical history, physical examination, and diagnostic tests, often can be treated and experience improved quality of life. The pathophysiological mechanisms behind dysphagia, its diagnosis, and potential treatments are discussed in this manuscript.
吞咽困难是许多神经疾病的常见症状。口咽吞咽困难的患者在开始吞咽时会出现困难，常伴有咳嗽和窒息；而食管吞咽困难的患者则描述为吞咽的食物停留在胸部的感觉。慢性神经系统疾病，如中风、帕金森病或痴呆症，常以吞咽困难为症状，特别是口咽吞咽困难，因此常使用“神经性吞咽困难”这一术语。吞咽的精细、综合感觉运动系统的紊乱通常是吞咽困难的主要原因。吞咽困难可伴有吸入导致吸入性肺炎，慢性吞咽困难可导致体重减轻和营养不良。通过病史、体格检查和诊断性检查准确、及时地诊断出吞咽困难的患者，通常可以得到治疗，并提高生活质量。本文讨论了吞咽困难的病理生理机制、诊断和潜在治疗方法。
