Swallowing Disorders in Severe Brain Injury in the Arousal Phase

Area of Science:

• Neurology
• Rehabilitation Medicine
• Clinical Medicine

Background:

• Severe acquired brain injury (sABI) often leads to significant neurological deficits.
• The arousal phase post-coma presents unique challenges for patient assessment and rehabilitation.
• Swallowing disorders (dysphagia) are a frequent complication impacting recovery and quality of life.

Purpose of the Study:

• To characterize the clinical features of swallowing disorders in patients with sABI during the arousal phase.
• To identify the prevalence and types of dysphagia in this specific patient population.
• To establish the importance of early swallowing evaluation for rehabilitation planning.

Main Methods:

• A cohort of eleven sABI patients in the arousal phase were evaluated.
• Swallowing assessment included functional examination, clinical functional swallowing test, and naso-endoscopic swallowing test.
• Data collected focused on oral and pharyngeal food bolus transport and airway protection mechanisms.

Main Results:

• All patients exhibited swallowing disorders upon admission.
• Oral (77.8%) and pharyngeal (66.7%) food bolus transport disorders were prevalent.
• Airway protection deficits (80%) and swallowing coordination issues (55.6%) were also significant findings.

Conclusions:

• Swallowing disorders are a major concern in the arousal phase of severe brain injury.
• Early bedside swallowing assessment is essential for timely and appropriate rehabilitation.
• Most patients who resumed oral feeding required modified food and liquid textures long-term.