New Techniques-Future

Abstract

Swallowing problems (dysphagia) are common after brain injuries such as Stroke, and can affect as many as 78% of patients in the period immediately after the injury. In some cases, compensatory recovery processes within the body can accommodate and restore a patients swallowing ability to a safe level within weeks of the brain injury. However, during that often protracted recovery period and in those patients who do not recover naturally, dysphagia can lead to serious morbidity, in particular malnutrition and pulmonary aspiration. Despite this, swallowing therapies remain controversial, with limited evidence base and little in the way of objective outcome measures that provide scientific support for their use. However, better technology and an increasing use of neurophysiological imaging and stimulation techniques have helped to improve our understanding of the cortical control of swallowing. Moreover, experimental treatments involving central and peripheral stimulation are now attracting a great deal of attention as a means to help some patients recover their swallowing to a safe level. This article will review some of the newer techniques potentially suitable for the treatment of dysphagia after stroke.