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Journal of the Korean Academy of Rehabilitation Medicine 2001;25(2):193-201.
Pattern of Post-Stroke Swallowing Disorder according to the Brain Lesion.
Lee, Chyung Ki , Kim, Jeong A
Department of Rehabilitation Medicine, Ewha Womans University.
뇌졸중 환자에서 뇌 병변 위치에 따른 연하곤란의 양상
이청기, 김정아
이화여자대학교 의과대학 재활의학과

Post-stroke dysphagia occurs in the form of lingual discoordination, pharyngeal dysmotility, and delayed swallowing reflex. The purpose of this study is to define the pattern of post-stroke swallowing disorder according to the location of brain lesion.

Thirty-nine post-stroke patients and ten normal persons participated to perform the videofluoroscopic swallowing study (VFSS) with fluid and semisolid gastrograffin. Brain lesions were classified by cortical, subcortical, or brainstem groups and by the involved hemisphere.

There was no difference of swallowing pattern between the cortical and subcortical lesions. However patients with brainstem lesion more frequently showed incomplete laryngeal elevation, prolonged pharyngeal transit time, failure of cricopharyngeal muscle relaxation, and aspiration than with cortical and subcortical lesions (p<0.01). In the patients with cortical and subcortical lesions, aspiration occurred before the laryngeal elevation due to discoordination of laryngopharynx. Whereas in the brainstem lesion, aspiration occurred after the laryngeal elevation due to incomplete laryngeal closure. Premature posterior spillage (p<0.05), poor laryngeal elevation(p<0.05), and tracheal aspiration (p<0.01) were more frequently seen in the patients with right hemispheric dysfunction than the left.

Discoordination of the tongue, oropharynx, and laryngopharynx is predominant in the cortical and subcortical lesion, whereas incomplete laryngeal closure and failure of cricopharyngeal muscle relaxation are predominant in the brianstem lesion.

Key Words: Videofluoroscopic swallowing study (VFSS), Dysphagia, Stroke


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