Dysphagia

, Volume 12 , Issue 4 , pp 188 -193

First online:

The Natural History of Dysphagia following a Stroke

  • David G.  SmithardAffiliated withDepartment of Geriatric Medicine, University Hospital of South Manchester, Manchester, UK
  • , Paul A.  O'NeillAffiliated withDepartment of Geriatric Medicine, University Hospital of South Manchester, Manchester, UK
  • , Ruth E.  EnglandAffiliated withDepartment of Radiology, University Hospital of South Manchester, Manchester, UK
  • , Clare L.  ParkAffiliated withDepartment of Speech and Language Therapy, University Hospital of South Manchester, Manchester, UK
  • , Rosemary  WyattAffiliated withDepartment of Speech and Language Therapy, University Hospital of South Manchester, Manchester, UK
  • , Derrick F.  MartinAffiliated withDepartment of Radiology, University Hospital of South Manchester, Manchester, UK
  • , Julie  MorrisAffiliated withDepartment of Medical Statistics, University Hospital of South Manchester, Manchester, UK

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Abstract.

To assess the frequency and natural history of swallowing problems following an acute stroke, 121 consecutive patients admitted within 24 hours of the onset of their stroke were studied prospectively. The ability to swallow was assessed repeatedly by a physician, a speech and language therapist, and by videofluoroscopy. Clinically 51% (61/121) of patients were assessed as being at risk of aspiration on admission. Many swallowing problems resolved over the first 7 days, through 28/110 (27%) were still considered at risk by the physician. Over a 6-month period, most problems had resolved, but some patients had persistent difficulties (6, 8%), and a few (2, 3% at 6 months) had developed swallowing problems. Ninety-five patients underwent videofluoroscopic examination within a median time of 2 days; 21 (22%) were aspirating. At 1 month a repeat examination showed that 12 (15%) were aspirating. Only 4 of these were persistent; the remaining 8 had not been previously identified. This study has confirmed that swallowing problems following acute stroke are common, and it has been documented that the dysphagia may persist, recur in some patients, or develop in others later in the history of their stroke.

Key words: Dysphagia — Aspiration — Stroke — Natural history — Deglutition — Deglutition disorders.