Therapy-resistant dysphagia successfully treated using pharyngeal electrical stimulation in a patient with the pharyngeal-cervical-brachial variant of the Guillain-Barré syndrome

Abstract

Pharyngeal electrical stimulation (PES) is a novel treatment for oropharyngeal dysphagia resulting from neurogenic causes such as stroke, prolonged intubation, tracheostomy, or multiple sclerosis, and may be effective in other medical conditions such as Guillain-Barré syndrome (GBS). A 74-year-old male patient with a pharyngeal-cervical-brachial (PCB) variant of GBS, who had been tracheotomised due to severe and persistent swallowing difficulties (dysphagia) unresponsive to traditional speech and language therapy, received PES therapy as a final treatment option. Swallow performance evaluated before and after PES using fibreoptic endoscopic evaluation of swallowing, videofluoroscopy and clinical bedside assessment, showed significant improvement in swallowing resulting in safe tracheostomy decannulation 18 days after PES. In PCB GBS, we present the potential benefit of PES for the treatment of persistent dysphagia and faster tracheostomy decannulation. PES was safe and may be beneficial in other neurologic disorders, where traditional dysphagia therapies have proved unsuccessful.