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Published on: August 11, 2023

Swallowing Apraxia Post Ischemic Stroke.

Abdullah Mohammed Alfaris¹, Atheer Saeed Alghamdi¹, Enas Saad Almowalad²

¹Rehabilitation Department, King Abdullah Bin Abdulaziz University Hospital, P.O. Box 47330, Riyadh 11552, Saudi Arabia.

International Journal of Environmental Research and Public Health

|December 11, 2022

Summary

This case study identifies swallowing apraxia as the cause of dysphagia in a patient with ischemic stroke. Videofluoroscopic swallowing study (VFSS) was crucial in diagnosing this oral and pharyngeal phase swallowing dysfunction.

Keywords:

FEES VFSS ischemic stroke swallowing apraxia

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Area of Science:

Neurology
Gastroenterology
Speech-Language Pathology

Background:

Ischemic stroke can lead to complex neurological deficits, including swallowing difficulties (dysphagia).
Accurate diagnosis of dysphagia subtypes is essential for effective patient management and rehabilitation.

Observation:

A 55-year-old male with type 2 diabetes and treated lymphoma presented with acute ischemic stroke.
Initial bedside and FEES assessments did not fully elucidate the cause of dysphagia.
Videofluoroscopic swallowing study (VFSS) revealed significant oral phase dysfunction and difficulty initiating the pharyngeal phase.

Findings:

The patient exhibited symptoms consistent with swallowing apraxia, characterized by impaired oral preparation and transit, and delayed pharyngeal swallow initiation.
VFSS proved more sensitive than FEES in identifying the specific oral and pharyngeal phase deficits.

Implications:

This case highlights the importance of VFSS in diagnosing swallowing apraxia following stroke.
Understanding swallowing apraxia is critical for tailoring therapeutic interventions and improving patient outcomes.
The findings contribute to the literature on neurogenic dysphagia management.