Standardisierung des Untersuchungsablaufs bei neurogener oropharyngealer Dysphagie (NOD) – Evaluation des NOD-Stufenkonzeptes

Ickenstein, GW; Prosiegel, Mario; Höhlig, C; Bräuer, G; Koch, H; Muller, Renata Medeiros Lobo; Becker, Ulrik; Riecker, Axel

doi:10.1055/s-0029-1238590

Cited by 13 publications

(14 citation statements)

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“…During their initial inpatient rehabilitation treatment each patient underwent a clinical examination at admission and discharge based on the clinical part of the neurogenic oropharyngeal dysphagia test (NOD, Ickenstein et al, 2009). The following components were investigated: facio-oral motor and somatosensory functions, inspection of the oral cavity and an assessment of somatomotor pharyngeo-laryngeal function.…”

Section: Methodsmentioning

confidence: 99%

Brain imaging correlates of recovered swallowing after dysphagic stroke: A fMRI and DWI study

Mihai

Otto

Domín

et al. 2016

NeuroImage: Clinical

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Neurogenic dysphagia frequently occurs after stroke and deglutitive aspiration is one of the main reasons for subacute death after stroke. Although promising therapeutic interventions for neurogenic dysphagia are being developed, the functional neuroanatomy of recovered swallowing in this population remains uncertain. Here, we investigated 18 patients post-stroke who recovered from dysphagia using an event related functional magnetic resonance imaging (fMRI) study of swallowing. Patients were characterized by initial dysphagia score (mild to severe), lesion mapping, white matter fractional anisotropy (FA) of the pyramidal tracts, and swallowing performance measurement during fMRI scanning. Eighteen age matched healthy participants served as a control group. Overall, patients showed decreased fMRI-activation in the entire swallowing network apart from an increase of activation in the contralesional primary somatosensory cortex (S1). Moreover, fMRI activation in contralesional S1 correlated with initial dysphagia score. Finally, when lesions of the pyramidal tract were more severe, recovered swallowing appeared to be associated with asymmetric activation of the ipsilesional anterior cerebellum. Taken together, our data support a role for increased contralesional somatosensory resources and ipsilesional anterior cerebellum feed forward loops for recovered swallowing after dysphagia following stroke.

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Section: Methodsmentioning

confidence: 99%

Brain imaging correlates of recovered swallowing after dysphagic stroke: A fMRI and DWI study

Mihai

Otto

Domín

et al. 2016

NeuroImage: Clinical

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“…For clinical swallowing examination we used the NOD-Stepwise Concept. 4 Instrumental assessment to visualise the structure and functions of the different stages of swallowing and to identify the risk of aspiration was Fiberoptic Endoscopic Evaluation of Swallowing (FEES). The examination was complemented by the Swallowing Quality of life survey (SWAL-QOL).…”

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confidence: 99%

H1 Dysphagia in huntington’s disease: symptoms and a patient perspective

Heemskerk

2016

J Neurol Neurosurg Psychiatry

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BackgroundDysphagia is a frequent finding in patients with HD. Up to 75% of the patients die of aspiration pneumonia. Symptoms of dysphagia already start in the very beginning of HD and become more severe when the disease progresses. The different symptoms of dysphagia in HD are already known. It is also known that there are treatment possibilities for dysphagia, such as the Masako and the Mendelsohn manoeuvre, but these are validated for other diseases, like a cerebro vascular accident or Parkinson’s disease. There is no evidence that patients with HD benefit from this treatment. In our experience with HD, patients do benefit from dysphagia treatment. In this presentation dysphagia symptoms are presented using X-ray imaging, further, some treatment possibilities for dysphagia will be introduced by presenting a case study. MethodX-ray images on dysphagia symptoms during the different stages of HD were collected. More than 30 HD patients with dysphagia were treated using the Masako and Mendelsohn manoeuvre. For one specific patient a video was made to make a report of her swallowing progress.ResultsX-ray images of dysphagia in HD were collected and will be shown in the presentation. More than 30 HD patients were treated for dysphagia using the Masako and Mendelsohn manoeuvre. Most patients could perform at least one manoeuvre, and most patients reported that they benefit from the treatment. For one specific patient a video was made to document the swallowing progress. The video was published on .ConclusionAn impressive collection of X-ray imaging on dysphagia in HD exists. For treatment possibilities, patients with HD seem to benefit from especially the Masako and Mendelsohn manoeuvre. For one patient the findings were documented and recorded on a video. This video was published on , and parts of this video will be presented during the presentation.

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“…To enhance interprofessional communication and to allow for a smooth and efficient workflow, endoscopic grading of stroke-related dysphagia should adopt a standardized score that also includes protective and rehabilitative measures as well as nutritional recommendations. Nowadays, the systematic evaluation of neurogenic oropharyngeal dysphagia (NOD) in stroke units is based on a 3-step procedure [24][25][26].…”

Section: The Role Of Endoscopy In Stroke Unitsmentioning

confidence: 99%

“…3. Algorithm of dysphagia screening in stroke units adopted and modified from [24][25][26]. KSA = Evaluation of medical history for swallowing; KSU = clinical swallowing assessment.…”

Section: Disclosure Statementmentioning

confidence: 99%

The Role of the Endoscopist in the Stroke Unit

Frieling

2016

Visc Med

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Background: Acute cerebral stroke is a common problem that is frequently associated with dysphagia resulting in an increased risk of aspiration pneumonia, complication, and mortality. Methods: A literature review was carried out using the search terms ‘stroke unit and endoscopy', ‘stroke unit and dysphagia', and ‘stroke unit and gastroenterology'. Results: Only few papers focus on the role of endoscopy in stroke units. One major role is the early detection of dysphagia by flexible endoscopic evaluation of swallowing (FEES). FEES appears to have a higher sensitivity and specificity compared to bedside tests and challenges videofluoroscopy. In contrast, other stroke-associated gastrointestinal complications requiring endoscopic diagnostic or therapeutic intervention, such as gastrointestinal bleeding, abdominal pain, or stasis, and the need to provide fluid and food via gastrostomy or jejunostomy are rarely seen in stroke units and become relevant during and after the rehabilitation phase. Conclusion: FEES should involve an interdisciplinary team comprising neurologists, speech and language pathologists and/or therapists, as well as gastroenterologic endoscopists.

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Standardisierung des Untersuchungsablaufs bei neurogener oropharyngealer Dysphagie (NOD) – Evaluation des NOD-Stufenkonzeptes

Cited by 13 publications

References 0 publications

Brain imaging correlates of recovered swallowing after dysphagic stroke: A fMRI and DWI study

Brain imaging correlates of recovered swallowing after dysphagic stroke: A fMRI and DWI study

H1 Dysphagia in huntington’s disease: symptoms and a patient perspective

The Role of the Endoscopist in the Stroke Unit

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