Retrospective study of prognostic factors of dysphagia due to acute lateral medullary ischemic lesion: Usefulness of water swallowing evaluation Tomohiro Suzuki 1 , Keishi Fujita 2 , Harumi Tabuchi 1 , Kumiko Oshima 1 , Fumika Makino 1 , Kazuya Numajiri 1 1Department of Rehabilitation, Ibaraki Seinan Medical Center Hospital 2Department of Neurological Surgery, Ibaraki Seinan Medical Center Hospital Keyword: 延髄外側虚血性病変 , 嚥下障害 , 急性期 , 予後予測 , 飲水評価 , lateral medullary ischemic lesion , dysphagia , acute phase , prognostic prediction , water swallowing evaluation pp.19-26
Published Date 2018/3/15
DOI https://doi.org/10.11477/mf.6001200159
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 It has been reported that dysphagia due to ischemic lesions in the lateral medulla oblongata improves early in the disease course in some cases but not in others. Thus, it is difficult to predict the prognosis of the dysphagia. In order to identify possible predictive factors, we retrospectively studied 10 patients with dysphagia due to ischemic lesions in the lateral medulla oblongata. The following factors were evaluated:age, presence of consciousness disturbance, presence of soft palate paralysis, presence of hoarseness, presence of cough reflex, and the water swallowing evaluation. The end-point was the necessity of tube-feeding 2 months after the stroke onset. The patients who passed the water swallowing evaluation within 2 weeks of the stroke onset left tube-feeding at a significantly higher rate than the patients who did not. No significant differences were observed in the other factors evaluated. We therefore suggest that in patients with dysphagia due to lateral medullary ischemic lesions, passing the water swallowing evaluation in the acute phase can be a predictor that the patient will leave tube-feeding at a relatively early stage.

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