Manometric abnormality in dysphagic patients after medullary cerebrovascular accidents.

We investigated the pharyngeal swallowing function using videomanofluorometry (VMF) in patients after medullary cerebrovascular accidents. Upper esophageal sphincter pressure, which should drop when a bolus arrives at the hypopharynx, increased at the same time as the elevation of oropharyngeal and hypopharyngeal pressures. A reduction of oropharyngeal and hypopharyngeal swallowing pressures was also observed. Our results suggest that a misprogrammed excitatory output from the central pattern generators of the brain stem would cause an abnormal pressure-traveling pattern of pharyngeal swallowing. VMF was useful to assess the pharyngeal swallowing function and to determine the indications for cricopharyngeal myotomy for patients after medullary cerebrovascular accidents.