Swallowing after unilateral stroke of the cerebral cortex: Preliminary experience
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In an attempt to impose an organizational format on the specific effects that isolated stroke syndromes have on swallowing ability, we have developed a systematic approach to investigating the underlying neural control mechanisms in patients with clinical and computed tomographic evidence of unilateral ischemic stroke involving the cerebral cortex. When compared to findings in normal controls, initiation of the pharyngeal response was delayed in all stroke subjects. Left cortical stroke dysphagia was characterized primarily by impaired oral stage function, difficulty initiating coordinated motor activity, and apraxia. Right cortical stroke dysphagia was characterized primarily by pharyngeal pooling, penetration, and aspiration. Thus, these preliminary data indicate distinct patterns of dysphagia after unilateral cortical stroke and challenge the traditional classification of swallowing as a bilateral and brainstem-mediated activity.
Key wordsNeurogenic dysphagia Stroke, unilateral cerebral cortical Aspiration
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