Programa de Pós-graduação de Ciências Aplicadas a Saúde - PPGCAS, Universidade Federal de Sergipe - UFS - Lagarto (SE), Brasil.
Departamento de Fonoaudiologia, Universidade Federal de Sergipe - UFS - São Cristóvão (SE), Brasil.
Codas. 2023 Oct 30;35(5):e20210220. doi: 10.1590/2317-1782/20232021220pt. eCollection 2023.
This case report aimed to evaluate the swallowing capacity and the severity of the risk of laryngotracheal aspiration of a 52-year-old female patient with atypical and rare stroke, with major injury in the cerebellar pathway. In order to measure swallowing capacity and risk of aspiration a routine clinical assessment used in the speech therapy clinic was performed and two valid clinical tests were used: Massey Bedside Swallowing Screen (MBSS) and Gugging Swallowing Screen (GUSS). After evaluation with the clinical tests, it was observed that the patient had reduced swallowing capacity, performance characterized as pathological, 100% dysfunction in the water swallowing test (MBSS), presence of choking, coughing, change in vocal quality and anterior escape. In the assessment of risk of aspiration with the GUSS, the patient presented moderate dysphagia and risk of laryngotracheal aspiration.This case report demonstrated that moderate dysphagia is found in a stroke patient with lesions that affect the cerebellum. Standardized and validated clinical tests such as GUSS and MBSS should also be used to assess the risk of dysphagia after stroke at ambulatory care.
本病例报告旨在评估一位 52 岁女性非典型且罕见脑卒中患者的吞咽能力和误吸风险的严重程度，该患者的小脑通路上存在严重损伤。为了测量吞咽能力和误吸风险，在言语治疗诊所进行了常规临床评估，并使用了两种有效的临床测试：Massey 床边吞咽筛查（MBSS）和 Gugging 吞咽筛查（GUSS）。经过临床测试评估后，发现该患者的吞咽能力下降，表现为病理性，水吞咽测试（MBSS）的功能障碍为 100%，存在呛咳、咳嗽、声音质量改变和前向逃逸。在使用 GUSS 评估误吸风险时，患者表现出中度吞咽困难和发生喉气管误吸的风险。本病例报告表明，在影响小脑的脑卒中患者中可发现中度吞咽困难。标准化和验证的临床测试，如 GUSS 和 MBSS，也应在门诊护理中用于评估脑卒中后吞咽困难的风险。
