An unusual but easily treatable cause of dysphagia and dysarthria complicating stroke.

Wright, Alfred

doi:10.1136/bmj.291.6506.1412

Cited by 3 publications

(2 citation statements)

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“…The temporomandibular joint allows chewing, swallowing, and speaking [32]. Stroke patients may have temporomandibular joint disorders with a dislocation of the temporomandibular joint because of limited jaw movement and pain [33,34]. In this review, some studies [4,7,13,26] reported that dysfunction of the temporomandibular joint is associated with mouth opening limitation and asymmetrical mandibular movements.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Rehabilitation Strategies for the Stomatognathic System Disturbances in Patients with Stroke: A Systematic Review

Zapata-Soria

Cabrera‐Martos

López‐López

et al. 2022

IJERPH

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Background: Understanding the stomatognathic system disturbances is key to diagnosing them early and implementing rehabilitation approaches to promote functional recovery. The objective of this study was to systematically review all published data that examined the assessment and rehabilitation strategies for the stomatognathic system disturbances in patients with stroke. Methods: Five databases (i.e., PubMed/MEDLINE, Scopus, Science Direct, Web of Science, and PEDro), were screened for manuscripts that included the assessment and rehabilitation strategies for stomatognathic system disturbances. The methodological quality was evaluated using the Mixed Methods Appraisal Tool. Results: Sixteen articles were included in this systematic review. The most frequently reported symptoms in patients with stroke included stiffness and thickness of the masseter muscle on the affected side and suprahyoid muscles; facial muscles’ asymmetry and weakness; temporomandibular disorders; and a reduced maximum lip force, tongue pressure, and saliva flow rate. The rehabilitation strategies more frequently reported included exercises directed to the jaw, temporomandibular joint, tongue, and neck. The mean score for methodological quality was 85%. Conclusion: The stomatognathic system disturbances are frequently reported among patients with stroke, leading to dysfunction in masticatory performance or swallowing. More studies on interventions for stomatognathic system disturbances are required before conclusions may be drawn. Key Practitioner Message: This systematic review has clinical implications for rehabilitation practices, given that the results may help to develop early assessment and rehabilitation strategies for stomatognathic disturbances in patients with stroke.

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Rehabilitation Strategies for the Stomatognathic System Disturbances in Patients with Stroke: A Systematic Review

Zapata-Soria

Cabrera‐Martos

López‐López

et al. 2022

IJERPH

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“…Common direct trigger factors for TMJ dislocation are yawning and treatments that require wide opening of the mouth, such as dental treatments, intratracheal interventions, and endoscopic examination. A broad range of neuromuscular and neurological disorders, including stroke, can cause involuntary TMJ dislocation (1,2). Weakness of the mouth-closing muscles innervated by the motor branch of the trigeminal nerve might be a cause of TMJ dislocation in stroke patients (2).…”

Section: Introductionmentioning

confidence: 99%

Temporomandibular joint dislocation in a post-stroke patient with dysphagia caused by gastroesophageal reflux-related vomiting

et al. 2016

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Screening for Oropharyngeal Dysphagia in Stroke: Insufficient Evidence for Guidelines

2000

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There is no evaluation of the evidence for the screening of oropharyngeal dysphagia in stroke. We reviewed the literature on clinical screening for oropharyngeal dysphagia in adults with stroke to determine (a) the accuracy of different screening tests used to detect dysphagia defined by abnormal oropharyngeal physiology on videofluoroscopy and (b) the health outcomes reported and whether screening alters those outcomes. Peer-reviewed English-language and human studies were sought through Medline (from 1966 to July 1997) by using the key words cerebrovascular disorders and deglutition disorders, relevant Internet addresses, and extensive hand searching of bibliographies of identified articles. Of the 154 sources identified, 89 articles were original, peer-reviewed, and focused on oropharyngeal dysphagia in stroke patients. To evaluate the evidence, the next selection identified 10 articles on the comparison of screening and videofluoroscopic findings and three articles on screening and health outcomes. Evidence was rated according to the level of study design by using the values of the Canadian Task Force on Periodic Health Examination. From the identified screening tests, most of the screenings were related to laryngeal signs (63%) and most of the outcomes were related to physiology (74%). Evidence for screening accuracy was limited because of poor study design and the predominant use of aspiration as the diagnostic reference. Only two screening tests were identified as accurate: failure on the 50-ml water test (likelihood ratio = 5.7, 95% confidence interval = 2.5-12.9) and impaired pharyngeal sensation (likelihood ratio = 2.5, 95% confidence interval = 1.7-3.7). Limited evidence for screening benefit suggested a reduction in pneumonia, length of hospital stay, personnel costs, and patient charges. In conclusion, screening accuracy needs to be assessed by using both abnormal physiology and aspiration as diagnostic markers for dysphagia. Large well-designed trials are needed for more conclusive evidence of screening benefit.

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An unusual but easily treatable cause of dysphagia and dysarthria complicating stroke.

Cited by 3 publications

References 1 publication

Clinical Characteristics and Rehabilitation Strategies for the Stomatognathic System Disturbances in Patients with Stroke: A Systematic Review

Clinical Characteristics and Rehabilitation Strategies for the Stomatognathic System Disturbances in Patients with Stroke: A Systematic Review

Temporomandibular joint dislocation in a post-stroke patient with dysphagia caused by gastroesophageal reflux-related vomiting

Screening for Oropharyngeal Dysphagia in Stroke: Insufficient Evidence for Guidelines

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