Dysphagia in Neurological Disorders

Abstract

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.

The impact of physical therapy on dysphagia in neurological diseases: a review

“…Swallowing is a complex process, it involves the coordination of more than 30 muscles in the mouth, pharynx, larynx, and esophagus, encompassing four distinct stages: oral preparation, oral transit, pharynx, and esophageal phase ( Dodds et al, 1990 ). It involves various levels of the central nervous system, from the cortex to the medulla, as well as multiple cranial and peripheral nerves ( El Halabi et al, 2023 ). It is well recognized that pharyngeal movements are strongly related to the innervation of sensory branches of the cranial nerves ( Nascimento et al, 2021 ).…”

“…Neurogenic dysphagia is currently managed with motor training, oral medications, and surgery ( El Halabi et al, 2023 ). Clinical evidence supports the use of movement training for mild-to-moderate dysphagia ( Saconato et al, 2016 ), with strong recommendations from intermediate and high-level evidence sources ( Medicine DRCO, 2023 ; Yang et al, 2023 ).…”

“…The causes of dysphagia can be divided into neurogenic, structural, and mental dysphagia ( Medicine DRCO, 2023 ). A neurogenic dysphagia results from problems with the central and peripheral nervous systems ( El Halabi et al, 2023 ). The number of people suffering from neurogenic dysphagia each year worldwide is estimated at 400000 to 800,000 ( Panebianco et al, 2020 ).…”

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“…Swallowing is a complex process, it involves the coordination of more than 30 muscles in the mouth, pharynx, larynx, and esophagus, encompassing four distinct stages: oral preparation, oral transit, pharynx, and esophageal phase (Dodds et al, 1990). It involves various levels of the central nervous system, from the cortex to the medulla, as well as multiple cranial and peripheral nerves (El Halabi et al, 2023). It is well recognized that pharyngeal movements are strongly related to the innervation of sensory branches of the cranial nerves (Nascimento et al, 2021).…”

“…The causes of dysphagia can be divided into neurogenic, structural, and mental dysphagia (Medicine DRCO, 2023). A neurogenic dysphagia results from problems with the central and peripheral nervous systems (El Halabi et al, 2023). The number of people suffering from neurogenic dysphagia each year worldwide is estimated at 400000 to 800,000 (Panebianco et al, 2020).…”