TY - JOUR
T1 - The assessment of dysphagia after stroke
T2 - state of the art and future directions
AU - Labeit, Bendix
AU - Michou, Emilia
AU - Hamdy, Shaheen
AU - Trapl-Grundschober, Michaela
AU - Suntrup-Krueger, Sonja
AU - Muhle, Paul
AU - Bath, Philip M
AU - Dziewas, Rainer
N1 - Publisher Copyright:
© 2023 Elsevier Ltd
PY - 2023/9
Y1 - 2023/9
N2 - Dysphagia is a major complication following an acute stroke that affects the majority of patients. Clinically, dysphagia after stroke is associated with increased risk of aspiration pneumonia, malnutrition, mortality, and other adverse functional outcomes. Pathophysiologically, dysphagia after stroke is caused by disruption of an extensive cortical and subcortical swallowing network. The screening of patients for dysphagia after stroke should be provided as soon as possible, starting with simple water-swallowing tests at the bedside or more elaborate multi-consistency protocols. Subsequently, a more detailed examination, ideally with instrumental diagnostics such as flexible endoscopic evaluation of swallowing or video fluoroscopy is indicated in some patients. Emerging diagnostic procedures, technical innovations in assessment tools, and digitalisation will improve diagnostic accuracy in the future. Advances in the diagnosis of dysphagia after stroke will enable management based on individual patterns of dysfunction and predisposing risk factors for complications. Progess in dysphagia rehabilitation are essential to reduce mortality and improve patients' quality of life after a stroke.
AB - Dysphagia is a major complication following an acute stroke that affects the majority of patients. Clinically, dysphagia after stroke is associated with increased risk of aspiration pneumonia, malnutrition, mortality, and other adverse functional outcomes. Pathophysiologically, dysphagia after stroke is caused by disruption of an extensive cortical and subcortical swallowing network. The screening of patients for dysphagia after stroke should be provided as soon as possible, starting with simple water-swallowing tests at the bedside or more elaborate multi-consistency protocols. Subsequently, a more detailed examination, ideally with instrumental diagnostics such as flexible endoscopic evaluation of swallowing or video fluoroscopy is indicated in some patients. Emerging diagnostic procedures, technical innovations in assessment tools, and digitalisation will improve diagnostic accuracy in the future. Advances in the diagnosis of dysphagia after stroke will enable management based on individual patterns of dysfunction and predisposing risk factors for complications. Progess in dysphagia rehabilitation are essential to reduce mortality and improve patients' quality of life after a stroke.
KW - Humans
KW - Deglutition Disorders/diagnosis
KW - Quality of Life
KW - Stroke/complications
KW - Risk Factors
UR - http://www.scopus.com/inward/record.url?scp=85167784825&partnerID=8YFLogxK
U2 - 10.1016/S1474-4422(23)00153-9
DO - 10.1016/S1474-4422(23)00153-9
M3 - Review article
C2 - 37596008
SN - 1474-4422
VL - 22
SP - 858
EP - 870
JO - The Lancet Neurology
JF - The Lancet Neurology
IS - 9
ER -