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Therapy of Dysphagia by Prolonged Pharyngeal Electrical Stimulation (Phagenyx) in a Patient with Brainstem Infarction

Dysphagia after stroke impacts quality of life and is a risk factor for respiratory infections. Patients frequently require prophylactic measures including nasogastric tube or percutaneous endoscopic gastrostomy. Until recently, therapy for dysphagia was limited to training with a speech and languag...

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Autores principales: Florea, Cristina, Bräumann, Christine, Mussger, Christine, Leis, Stefan, Hauer, Larissa, Sellner, Johann, Golaszewski, Stefan M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7287930/
https://www.ncbi.nlm.nih.gov/pubmed/32353976
http://dx.doi.org/10.3390/brainsci10050256
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author Florea, Cristina
Bräumann, Christine
Mussger, Christine
Leis, Stefan
Hauer, Larissa
Sellner, Johann
Golaszewski, Stefan M.
author_facet Florea, Cristina
Bräumann, Christine
Mussger, Christine
Leis, Stefan
Hauer, Larissa
Sellner, Johann
Golaszewski, Stefan M.
author_sort Florea, Cristina
collection PubMed
description Dysphagia after stroke impacts quality of life and is a risk factor for respiratory infections. Patients frequently require prophylactic measures including nasogastric tube or percutaneous endoscopic gastrostomy. Until recently, therapy for dysphagia was limited to training with a speech and language specialist. Intraluminal pharyngeal electrical stimulation (PES) is a new technique that stimulates the pharyngeal sensory afferents to the higher swallowing center in cortex. The clinical trials published to date involved stimulation for 10 minutes over three days. We present a case of brainstem infarction with severe dysphagia in a 53-year-old woman with preserved cognitive functions. For airway protection, she had a surgical tracheotomy. The initial swallowing training achieved slight improvements, but stagnated after three months so PES was tried. Under good PES tube tolerance, a prolonged and repeated stimulation protocol was administered, with the main purpose of relieving her of the tracheal tube. Although the swallowing improved, she stayed tube-dependent with minimal attempts with puréed food during therapy, and could not be decannulated. Further studies are required to assess the value of this promising approach for the treatment of dysphagia.
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spelling pubmed-72879302020-06-15 Therapy of Dysphagia by Prolonged Pharyngeal Electrical Stimulation (Phagenyx) in a Patient with Brainstem Infarction Florea, Cristina Bräumann, Christine Mussger, Christine Leis, Stefan Hauer, Larissa Sellner, Johann Golaszewski, Stefan M. Brain Sci Case Report Dysphagia after stroke impacts quality of life and is a risk factor for respiratory infections. Patients frequently require prophylactic measures including nasogastric tube or percutaneous endoscopic gastrostomy. Until recently, therapy for dysphagia was limited to training with a speech and language specialist. Intraluminal pharyngeal electrical stimulation (PES) is a new technique that stimulates the pharyngeal sensory afferents to the higher swallowing center in cortex. The clinical trials published to date involved stimulation for 10 minutes over three days. We present a case of brainstem infarction with severe dysphagia in a 53-year-old woman with preserved cognitive functions. For airway protection, she had a surgical tracheotomy. The initial swallowing training achieved slight improvements, but stagnated after three months so PES was tried. Under good PES tube tolerance, a prolonged and repeated stimulation protocol was administered, with the main purpose of relieving her of the tracheal tube. Although the swallowing improved, she stayed tube-dependent with minimal attempts with puréed food during therapy, and could not be decannulated. Further studies are required to assess the value of this promising approach for the treatment of dysphagia. MDPI 2020-04-28 /pmc/articles/PMC7287930/ /pubmed/32353976 http://dx.doi.org/10.3390/brainsci10050256 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Florea, Cristina
Bräumann, Christine
Mussger, Christine
Leis, Stefan
Hauer, Larissa
Sellner, Johann
Golaszewski, Stefan M.
Therapy of Dysphagia by Prolonged Pharyngeal Electrical Stimulation (Phagenyx) in a Patient with Brainstem Infarction
title Therapy of Dysphagia by Prolonged Pharyngeal Electrical Stimulation (Phagenyx) in a Patient with Brainstem Infarction
title_full Therapy of Dysphagia by Prolonged Pharyngeal Electrical Stimulation (Phagenyx) in a Patient with Brainstem Infarction
title_fullStr Therapy of Dysphagia by Prolonged Pharyngeal Electrical Stimulation (Phagenyx) in a Patient with Brainstem Infarction
title_full_unstemmed Therapy of Dysphagia by Prolonged Pharyngeal Electrical Stimulation (Phagenyx) in a Patient with Brainstem Infarction
title_short Therapy of Dysphagia by Prolonged Pharyngeal Electrical Stimulation (Phagenyx) in a Patient with Brainstem Infarction
title_sort therapy of dysphagia by prolonged pharyngeal electrical stimulation (phagenyx) in a patient with brainstem infarction
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7287930/
https://www.ncbi.nlm.nih.gov/pubmed/32353976
http://dx.doi.org/10.3390/brainsci10050256
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