Background: Dysphagia occurs following acute stroke and is an important cause of disability amongst these patients especially in posterior circulation stroke. 

 Aim: To investigate the effect of combined early swallow therapy along with the pattern of recovery in patients with the lateral medullary syndrome. 

Method: A total of 72 patients with lateral medullary syndrome were enrolled in the study and all were divided based on their site of lesion, age, gender and duration of therapy. Clinical bedside swallowing assessment was done on day 5 of their admission and graded based on National Outcomes Measurements Systems (NOMS), Penetration Aspiration Scale (PAS) and Fiberoptic Endoscopic Evaluation of Swallowing Test (FEEST). All patients received Intensive Traditional and Vital stim Electrical Therapy for 60 minutes. Swallowing assessment was repeated every 5 days. The outcomes were assessed based on NOMS and the duration of the therapy sessions were measured until they reached Level-5 based on NOMS.

Results: Out of 72 patients, 31.9% had a right sided lesion, 52.8% had a left-sided lesion and 15.3% had bilateral infarcts with no statistically significant difference in dysphagia outcomes.  At the end of the treatment, all patients had significant swallowing improvement after therapy. Also, a statistically significant difference was noted between their durational periods (p < 0.05).
Conclusion: Patients with lateral medullary syndrome with dysphagia show significant improvement in swallowing function after receiving combined early swallow therapy. Subjecting patients to this modality of therapy can help in reducing the morbidity associated with this illness.

References:

1.Kim H, Chung CS, Lee KH, Robbins J (2005) Aspiration subsequent to a pure medullary infarction: lesion site, clinical variables and outcome. Arch neurol 57(4): 478-483. 
2. Khedr EM, Abo-Elfetoh N (2010) Therapeutic role on recovery of dysphagia in patients with lateral medullary syndrome and brainstem infarction. J Neural Neurosurgical Psychiatry 81(5): 495-499.

EFFECT OF COMBINED EARLY SWALLOW THERAPY AND FUNCTIONAL OUTCOME MEASUREMENTS IN PATIENTS WITH LATERAL MEDULLARY SYNDROME