Comparison of disordered swallowing patterns in patients with recurrent cortical/subcortical stroke and first-time brainstem stroke.

OBJECTIVE

To describe the disordered swallowing patterns in recurrent cortical/subcortical stroke and first-time brainstem stroke.

DESIGN

A retrospective study.

SUBJECTS: Forty-seven consecutive patients, 28 with recurrent cortical/subcortical stroke and 19 with first-time brainstem stroke, referred for dysphagic evaluation to the rehabilitation department of a medical centre.

METHODS

Thirty-five male and 12 female patients with a mean age of 62.0+/-11.5 years were included. The median post-stroke duration was 17.0 days. The records of clinical examination and a videofluoroscopic study of swallowing were collected through chart review. The percentages of abnormalities seen at clinical examination and videofluoroscopic swallowing study between recurrent cortical/subcortical stroke and first-time brainstem stroke patients were compared using a chi-square test.

RESULTS

The recurrent cortical/subcortical patients suffered from a higher rate of impaired tongue movement, drooling and aphasia at clinical examination and a higher percentage of swallowing abnormalities in oral-preparatory and oral phases in the videofluoroscopic swallowing study. The abnormal videofluoroscopic findings in first-time brainstem stroke patients predominantly occurred in the pharyngeal phase. Both groups had more difficulties swallowing thin barium than they did swallowing the thick and paste barium.

CONCLUSION

The recurrent cortical/subcortical stroke and first-time brainstem stroke patients show different manifestations in some parameters of both clinical examination and videofluoroscopic swallowing study.