Abstract
Data from 357 conscious stroke patients taking part in an acute intervention trial and assessed within 48 hours of the onset of symptoms, were used to investigate the prevalence and natural history of swallowing problems. Nearly 30% of patients with single-hemisphere strokes were initially found to have difficulty swallowing a mouthful of water, but in most of those who survived, the deficit had resolved by the end of the first week. Strong correlations were found between dysphagia and speech impairment (comprehension and expression) and with facial weakness, but there was no association with the side of the stroke. After controlling for other markers of overall stroke severity such as conscious level, urinary continence, white blood cell count and strength in the affected limbs, swallowing impairment still showed a significant inverse correlation with functional ability at 1 and 6 months. These results indicate that, even if dysphagia itself is not responsible for much excess mortality in acute stroke, it might still lead to complications which hamper functional recovery.
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Selected References
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- Barer D. H., Cruickshank J. M., Ebrahim S. B., Mitchell J. R. Low dose beta blockade in acute stroke ("BEST" trial): an evaluation. Br Med J (Clin Res Ed) 1988 Mar 12;296(6624):737–741. doi: 10.1136/bmj.296.6624.737. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Barer D. H., Ebrahim S. B., Mitchell J. R. The pragmatic approach to stroke trial design: stroke register, pilot trial, assessment of neurological then functional outcome. Neuroepidemiology. 1988;7(1):1–12. doi: 10.1159/000110130. [DOI] [PubMed] [Google Scholar]
- Ebrahim S., Nouri F., Barer D. Measuring disability after a stroke. J Epidemiol Community Health. 1985 Mar;39(1):86–89. doi: 10.1136/jech.39.1.86. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gordon C., Hewer R. L., Wade D. T. Dysphagia in acute stroke. Br Med J (Clin Res Ed) 1987 Aug 15;295(6595):411–414. doi: 10.1136/bmj.295.6595.411. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Horner J., Massey E. W. Silent aspiration following stroke. Neurology. 1988 Feb;38(2):317–319. doi: 10.1212/wnl.38.2.317. [DOI] [PubMed] [Google Scholar]
- Ozaita G., Calandre L., Peinado E., Rodríguez-Antigüedad A., Bermejo F. Hematocrit and clinical outcome in acute cerebral infarction. Stroke. 1987 Nov-Dec;18(6):1166–1168. doi: 10.1161/01.str.18.6.1166. [DOI] [PubMed] [Google Scholar]
- Veis S. L., Logemann J. A. Swallowing disorders in persons with cerebrovascular accident. Arch Phys Med Rehabil. 1985 Jun;66(6):372–375. [PubMed] [Google Scholar]
- Willoughby E. W., Anderson N. E. Lower cranial nerve motor function in unilateral vascular lesions of the cerebral hemisphere. Br Med J (Clin Res Ed) 1984 Sep 29;289(6448):791–794. doi: 10.1136/bmj.289.6448.791. [DOI] [PMC free article] [PubMed] [Google Scholar]