Motilitätsstörungen der Speiseröhre bei Patienten mit apoplektischem Insult während der akuten Krankheitsphase

Although stroke affects mainly the oral and pharyngeal phases of swallowing, it may also impair esophageal contractions. Our hypothesis is that stroke may affect esophageal transit. The oral, pharyngeal, and esophageal transit was studied by the scintigraphic method in 26 patients (age range=26-83 years), eight of whom had mild dysphagia but all were able to feed orally and who had suffered an acute first-ever ischemic stroke 10-56 days (median = 43 days) before transit evaluation. The control group included 15 healthy volunteers (age range=27-86 years). All subjects swallowed a 5-ml liquid bolus and a 5-ml paste bolus labeled with technetium-99m phytate while sitting in front of the collimator of a gamma camara. The oral, pharyngeal, and proximal, middle, and distal esophageal transit was measured for 20 s. Three patients did not swallow the bolus during the scintigraphic evaluation. There was no difference between patients and controls with respect to oral and pharyngeal transit or clearance of liquid. For paste, the pharyngeal transit time was shorter for patients (0.48+/-0.17 s) than for controls (0.61+/-0.18 s, p=0.027). Also for the paste bolus, the residue in the mouth was greater in patients (18.4+/-13.6%) than in controls (10.2+/-4.9%, p=0.031). The liquid transit duration in the distal esophagus was shorter in patients with stroke (1.74+/-0.84 s) than in controls (2.68+/-1.65 s, p=0.028). There was no difference between patients and controls in esophageal residue. In conclusion, patients with stroke and able to feed orally may have alterations in the esophageal transit of a liquid bolus.

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A Scintigraphic Study of Oral, Pharyngeal, and Esophageal Transit in Patients with Stroke

Silva

Fábio

Dantas

2007

Dysphagia

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Physiology and pathology of the oesophagus in the elderly patient

Lock

2001

Best Practice & Research Clinical Gastroenterology

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Cortical processing of esophageal sensation is related to the representation of swallowing

Dziewas

Sörös²,

Ishii³

et al. 2005

NeuroReport

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The esophagus plays a major role in the act of swallowing. The aim of the present investigation was to apply whole-head magnetoencephalography in order to study the cortical processing of esophageal sensation in healthy humans in whom the cortical representation of swallowing had been established previously. The proximal esophagus was stimulated in nine participants by intermittent 5 ml water infusion. Submental EMG recording was used to identify trials, which were contaminated by subsequent swallowing. Esophageal stimulation led to changes in rhythmic activity of the brain that were localized in the left lateral primary sensorimotor cortex. The pattern of cortical activation showed the same hemispheric lateralization as that of volitional swallowing, however, being localized more lateral. The close anatomical vicinity of these two functions points to an important physiological link between the cortical processing of esophageal sensation and the cortical control of swallowing.

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Motilitätsstörungen der Speiseröhre bei Patienten mit apoplektischem Insult während der akuten Krankheitsphase

Cited by 5 publications

References 21 publications

A Scintigraphic Study of Oral, Pharyngeal, and Esophageal Transit in Patients with Stroke

A Scintigraphic Study of Oral, Pharyngeal, and Esophageal Transit in Patients with Stroke

Physiology and pathology of the oesophagus in the elderly patient

Cortical processing of esophageal sensation is related to the representation of swallowing

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