Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the course for this article:
 Volume 65, Number 5, September 13, 2005
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Related articles in Neurology
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kwon, M.
Right arrow Articles by Kim, J. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kwon, M.
Right arrow Articles by Kim, J. S.
NEUROLOGY 2005;65:714-718
© 2005 American Academy of Neurology

Dysphagia in unilateral medullary infarction

Lateral vs medial lesions

Miseon Kwon, PhD, Jae H. Lee, MD and Jong S. Kim, MD

From the Department of Neurology, University of Ulsan, Asan Medical Center, Seoul, South Korea.

Address correspondence and reprint requests to Dr. Jong S. Kim, Department of Neurology, Asan Medical Center, Song-Pa PO Box 145, Seoul 138-600, South Korea; e-mail: jongskim{at}amc.seoul.kr.

Objective: To study dysphagia in pure, unilateral medullary infarction using video fluoroscopic swallowing (VFS) tests and to compare the results between lateral medullary infarction (LMI) and medial medullary infarction (MMI).

Methods: We studied 46 patients with medullary infarction (37 LMI, 9 MMI). Based on the MRI findings, each LMI was classified rostrocaudally as either a rostral or caudal lesion, and horizontally as either a superficial (lateral + dorsal) or nonsuperficial lesion. Each MMI was assigned to either a deep (lesion extending to the dorsal surface) or superficial lesion group. VFS examination was conducted and an 8-point scale was used for assessing the severity of dysphagia. Based on these results, dysphagia was classified as: 1) problems on timing of hyolaryngeal excursion (PT), and 2) problems on range of hyolaryngeal excursion (PR).

Results: Dysphagia was more frequent (p < 0.05) in MMI patients (78%) than in LMI patients (35%). Among the LMI patients, dysphagia was more frequent (p < 0.01) and severe (p < 0.01) in the rostral than in the cadual group and in the nonsuperficial than in the superficial group. In the MMI group, there was no difference in the frequency of dysphagia between the deep and superficial groups. Regarding the characteristics of dysphagia, seven (54%) of the LMI patients had PR, five (38%) had PT, and one (8%) had both. For the MMI patients, PT was frequent (86%) but PR was present in only one patient (14%). Five MMI patients (71%) showed no responses to penetration or aspiration, and silent dysphagia was observed in only four LMI patients (31%).

Conclusions: Dysphagia is as frequent and severe in medial medullary infarction (MMI) as in lateral medullary infarction (LMI) patients. The types and characteristics of dysphagia are different between the LMI and MMI patients, implicating the rationale for a different treatment strategy.

Supported by Grant M103KV010005 03K2201 00540 from the Brain Research Center of the 21st Century Frontier Research Program, funded by the Ministry of Science and Technology, Republic of Korea.

Disclosure: The authors report no conflicts of interest.

Received November 24, 2004. Accepted in final form May 17, 2005.


Related articles in Neurology:

September 13 Highlights

Neurology 2005 65: 660-661. [Full Text]  





HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2005 by AAN Enterprises, Inc.