Neurogenic Dysphagia

This book is a clinical manual that covers the whole spectrum of swallowing and its disorders. It starts with physiology of swallowing, pathophysiology of disordered deglutition, diagnostic methods (clinical and instrumental) and ends with an in-depth’s and up-to-date presentation of current treatment options. The clinically most relevant topics of dysphagia management on the stroke unit and the intensive care unit are dealt with in separate chapters. Also the closely intertwined issue of nutritional management is specifically addressed. Most importantly, the book covers all obligatory topics of the Flexible Endoscopic Evaluation of Swallowing (FEES)-curriculum, an educational initiative that started in Germany in 2014 and is currently being extended to other European and non-European countries. The book is richly illustrated and an online video section provides a number of typical patient cases. FEES is probably the most commonly chosen method for the objective assessment of swallowing and its disorders. It is used in stroke units, intensive care facilities, geriatric wards but also in rehabilitation clinics and within dedicated outpatient services. This book on neurogenic dysphagia therefore addresses a wide range of different medical disciplines, such as neurologists, geriatricians, intensive care physicians, rehabilitation physicians, gastroenterologists, otolaryngologists, phoniatrists and also speech-language pathologists.

Dysphagia refers to any difficulty or problem with deglutition or bolus movement from the time the bolus is placed in the mouth until the time it enters the stomach. It affects around 16 million individuals in the USA and over 40 million individuals in Europe. Evaluation of dysphagia by a phoniatrician/speech-language pathologist (SLP) may consist of a clinical swallow evaluation and an instrumental assessment, such as a videofluoroscopic swallow study (VFSS) and fiberoptic endoscopic valuation of swallow (FEES). This resource is designed to benefit a broad audience, including phoniatricians, SLPs, trainee SLPs, physicians, nurses, dietitians, and occupational and physical therapists who work with populations who have dysphagia, as well as researchers in the field of swallowing disorders. Table of Contents: • Definition, etiology, epidemiology, symptoms and consequences • Normal swallowing and pathophysiology of dysphagia • Screening and clinical swallowing examination • Instrumental assessment • Management • Recent advances and future directions

Dysphagia refers to any difficulty or problem with deglutition or bolus movement from the time the bolus is placed in the mouth until the time it enters the stomach. It affects around 16 million individuals in the USA and over 40 million individuals in Europe. Evaluation of dysphagia by a phoniatrician/speech-language pathologist (SLP) may consist of a clinical swallow evaluation and an instrumental assessment, such as a videofluoroscopic swallow study (VFSS) and fiberoptic endoscopic valuation of swallow (FEES). This resource is designed to benefit a broad audience, including phoniatricians, SLPs, trainee SLPs, physicians, nurses, dietitians, and occupational and physical therapists who work with populations who have dysphagia, as well as researchers in the field of swallowing disorders. Table of Contents: • Definition, etiology, epidemiology, symptoms and consequences • Normal swallowing and pathophysiology of dysphagia • Screening and clinical swallowing examination • Instrumental assessment • Management • Recent advances and future directions

Clearly delineates the terminology and practices associated with compensatory versus rehabilitative treatment technique in neurogenic dysphagia. Includes comprehensive treatment planning and selection of techniques based on physiologic abnormalities, rather than symptomatology. Provides in-depth discussion of various biofeedback modalities and reviews the challenge of diet modification terminology and standard practices. Reviews surgical and pharmacological managemet of the dysphagia patient. TEXTBOOK

Swallowing is one of the primary functions that enable humans to sustain life. Likewise, it is an important element of healthy life and contributes to quality of life and well-being. When the ability to swallow is lost or impaired, the risk of disability or even death is greatly increased. Rehabilitation potential is diminished and the process is prolonged in the presence of dysphagia. This present chapter describes the anatomical and neurophysiological components of healthy adult swallowing and presbyphagia and the major consequences that swallowing disorders (dysphagia) may have if left untreated. The main neurogenic conditions and diseases leading to dysphagia are also introduced, as well as the major diagnostic and interventional approaches used by swallowing specialists to help patients with dysphagia. The role of the multidisciplinary team is emphasized and screening questions and guidelines are provided to help the neurologist and other professionals provide dysphagic patients with the best swallowing care.

Now with videos! Dysphagia Following Stroke, Third Edition is a practical and easy-to-use resource for clinicians treating swallowing disorders in the stroke population. The authors bridge the gap between academic and clinical practice with up-to-date research and clinical case examples throughout. In addition to a thorough overview of dysphagia diagnosis and management, this text focuses heavily on evaluation and management of stroke. Key topics include neural underpinnings of normal and disordered swallowing, swallowing screening, the clinical swallowing examination including cough reflex testing, the expanding array of instrumental swallowing modalities, and the rehabilitation of swallowing including strength training, non-invasive brain stimulation, and skill training. While geared toward practicing clinicians, Dysphagia Following Stroke is also useful for students in professional training programs. New to the Third Edition: A third author, Kristin Gozdzikowska, bring a fresh perspective as a young clinician and researcher with particular expertise in high resolution manometry and various cutting-edge treatment techniquesNew larger 6" x 9" trim sizeUpdated chapters on assessment to include new and emerging instrumental technologies, including high resolution manometry, impedance, and ultrasoundUpdated chapters on management to include the newly described International Dysphagia Diet Standardization InitiativeNew and expanded framework for rehabilitation, with a shift from peripherally focused rehabilitation to neuromodulation of cortical swallowing controlNew and updated research and trends in clinical practice throughoutIncludes videos This thoroughly updated and enhanced edition of Dysphagia Following Stroke is sure to remain a valued resource for clinicians working with stroke patients in all settings. Disclaimer: Please note that ancillary content (such as documents, audio, and video, etc.) may not be included as published in the original print version of this book.

The book offers a comprehensive approach to the assessment and treatment of disturbances in facial expression, oral movement, swallowing, breathing, voice and speech production caused by developmental and acquired neurological conditions. The principles outlined are used in patients with different etiologies (e.g. stroke, tumors, traumas). F.O.T. T., developed by Kay Coombes, is a hands-on approach based on an understanding of neurological functions and the way we learn from experience. The approach aims to give the patient experience of physiological posture and movement using facial-oral functions in normal activities of daily living (ADL). Rather than mere “exercises”, F.O.T.T involves meaningful activities aiming to promote participation, according to ICF criteria. Four main areas are covered: nutrition, oral hygiene, nonverbal communication and speech. Each chapter summarises the problems of severely ill patients and shows the clinical reasoning behind the solutions offered. Separate chapters discuss tracheostomy management and the training of the carers involved, including relatives. The chapter authors are experienced specialists (physio-, occupational- and speech-language therapists and physicians), whose contributions aim to provide interdisciplinary perspectives and translate latest research into clinical practice.