Hashimoto Y, Kimura K, Yonehara T, Uchino M, Ando M
Department of Cerebrovascular disease, Kumamoto City Hospital.
Rinsho Shinkeigaku. 1996 Jan;36(1):17-21.
We studied 10 patients with lateral medullary infarction. Six patients had severe dysphagia from the onset, and needed tube feeding or intravenous hyperalimentation. Three of these 6 patients resolved dysphagia within 3.5 months. Pharyngoesophagography showed aspiration and pooling in the pharynx in other three patients who showed persisting dysphagia for more than 6 months. The cause of dysphagia was not unilateral paralysis of the pharynx and the larynx. Because there were decreased functions of elevation of the larynx, closure of the vocal cord and the pharyngeal movement, the dysphagia of our patients may be due to disturbance of the neurogenic swallowing control. Persistent dysphagia was associated with anterolateral extension of the infarction in the medulla. Two patients with laryngectomy and permanent tracheostomy were able to be discharged to home. We conclude that surgical treatment is a choice in patients with dysphagia which persists for more than 6 months.
