Improve of dysphagia with electrostimulation after a stroke

Abstract

Patients who have suffered a stroke may have dysphagia in more than 30% of cases. When the alteration is located in the bulbar area, since the neural control of swallowing is located at the bulbar level, where the centers responsible for processing the afferent sensory signals and programming the motor deglutory sequence are located this percentage increases. The goal of treatment is to obtain secure and sufficient oral intake for adequate hydration and nutrition. Treatment techniques are designed to change the physiology of swallowing. Neuromuscular electrical stimulation can also be performed as studies have shown that this treatment appears to help people with moderate dysphagia. Clinical observation: we present the case of a 44-year-old woman who suffered laterobulbar ischemic Ictus. The physical exam, showed dysarthria, facial paresis and limb dysmetry without motor deficit and severe alteration of swallowing. Fibroendoscopic studies were performed and oral diet was contraindicated thus enteral nutrition was required from the time of admission. Speech therapy plus the application of electrostimulation was initiated. After 4 months of treatment, enteral nutrition was removed and the patient was able to change to a complete oral diet. Patients who are diagnosed of a bulbar stroke have a high percentage of swallowing dysfunction. Swallowing therapy with electrical stimulation may help clinical improvement of dysphagia.