Background: Lateral medullary syndrome is a known cause for apraxia, dysarthria, and dysphagia. It is caused by lesion in the posterolateral area of the medulla oblongata. Dysphagia, being a life-threatening condition, deserves immediate attention of the medical team and is of prime concern to Speech Language Pathologists (SLPs). Aim:The aim of the study was to document a successful case of dysphagia management in lateral medullary syndrome (LMS). Case report:This study documents a successful management of dysphagia in an individual with LMS. Assessment (perceptual and instrumental) showed reduction of peripheral capillary oxygen saturation (SpO 2 ) during feeding, slow laryngeal elevation with pooling of food and saliva in bilateral pyriform fossa, along with a high risk of penetration followed by aspiration. Weak tongue movement and improper lip closure were observed. Combinations of manual therapy and compensatory techniques were used for treating dysphagia. Oromotor exercises and respiratory exercises were used along with supraglottic maneuver, Masako maneuver, chin-tuck with effortful swallow, and Shaker's exercise. Within 2 weeks of initiation of swallow therapy, the subject could start safe oral intake with pureed food and maintain normal SpO 2 level during feeding. Conclusion:This case report demonstrates that dysphagia in LMS can be successfully treated with appropriate selection of combination of techniques in swallow therapy. Supraglottic swallow, Masako maneuver, chin-tuck, and Shaker's exercise were found effective in this case study. We further conclude that early initiation of therapy is the key to faster recovery.

This study was done to find the effectiveness of neuromuscular electrical stimulation (NMES) over anterior neck muscles. Sixteen patients, age range 50 to 80 years with pharyngeal dysphagia of neurological origin were included for study. A similar age-matched control group of 16 patients was taken from medical records. Detailed history, clinical assessment, investigations that are a flexible endoscopic evaluation of swallowing (FEES) and videofluoroscopic study of swallowing (VFS) was done. Subjective response (percentage of total diet taken orally) and penetration-aspiration scale (PAS) score at the beginning of treatment were noted. NMES was given to the study group along with swallow therapy. The suprahyoid muscles were stimulated regularly for 2 weeks. The reassessment was done after 2 weeks. The control group received only swallow therapy but no NMES. The results of the control group were also noted. Changes in the percentage of the total quantity of diet taken orally were asked. Upgradation in PAS score was assessed using FEES and VFS. The satisfactory improvement was found within 2 weeks in the study group. This took about 2 months in the control group. Hence, NMES was found to be an effective tool for dysphagia management.