Disfagija kod Lateralnog medularnog sindroma
Ključne reči:
lateralni medularni sindrom, disfagija, dijagnostika, tretman
Sažetak
Lateralni medularni sindrom je neurološko oboljenje izazvano ishemijom u bočnom delu produžene moždine i predstavlja najčešći oblik infarkta moždanog stabla. Disfagija je čest i klinički značajan simptom ovog oboljenja jer je usko povezan sa rizikom od ponovljene pneumonije, malnutricije, dehidracije, te sa povećanjem procenta mortaliteta i produženim bolničkim lečenjem. Cilj ovog rada je pregled i analiza podataka o korelaciji poremećaja gutanja i lateralnog medularnog sindroma. Namera nam je da na sveobuhvatan način prikažemo simptome, dijagnostičke i terapijske procedure disfagije kod pacijenata sa ovim sindromom. Za pretraživanje literature korišćene su sledeće baze podataka: KoBSON - Konzorcijum biblioteka Srbije za objedinjenu nabavku, PubMed, Science Direct. Na osnovu rezultata pregledanih studija utvrđeno je da pacijenti sa lateralnim medularnim sindromom često imaju poremećaje gutanja. Oni se neretko hrane putem nazogastrične sonde i po nekoliko meseci nakon moždanog udara, što značajno narušava njihov kvalitet života. U cilju prevazilaženja smetnji u gutanju i stvaranja uslova za bezbednu funkciju gutanja, većina pacijenata ima potrebu za tretmanom u dužem vremenskom intervalu. Pored dostupnih skrining testova, instrumentalne dijagnostičke metode omogućavaju uvid u biomehaničke aspekte poremećaja gutanja, determinišu rizik od aspiracije i predstavljaju polaznu osnovu za odabir strategija u tretmanu. Tretman disfagije zavisi od mehanizama nastanka i faktora predikcije oporavka funkcije gutanja. Pri sprovođenju tretmana, pored ostalog, veoma je važno poznavanje patoloških mehanizma neuralnih veza produžene moždine.
Ključne reči: laterani medularni sindrom, disfagija, dijagnostika, tretman
Reference
LITERATURE
1- Srivastava M, Abeetha S, Srivastava S. Posterior inferiror cerebellar artery syndrome. International Journal of Healthcare and Biomedical Research, 2015;3 (2):76-79.
2- Pavlović S, Stefanović N, Vučetić R, Antić S, Čukuranović R, Arsić S. Anatomija centralnog nervnog sistema i čula. Niš: Sven; 2006.
3- Bian R, Choi I, Kim J, Han J, Lee S. Impaired Opening of the Upper Esophageal Sphincter in Patients with Medullary Infarctions. Dysphagia. 2008;24(2):238-245.
4- Sacco R, Freddo L, Bello A, Odel G, Onesti T, Mohr P. Wallenbergs lateral medullary syndrome. Clinical magnetic resonance imaging correlation. Archives of neurology. 1993; 50 (6):609-614
5- Daniels S. Neurological disorders affecting oral, pharyngeal swallowing. GI Motility. 2006.
6- Vuković M. Poremećaji komunikacije kod traumatskih oštećenja mozga. Beograd: Univerzitet u Beogradu – Fakultet za specijalnu edukaciju i rehabilitaciju; 2012.
7- Saitoh E, Pongpipatbaiboon K, Inamoto Y, Kagaya H. Dysphagia Evaluation and Treatment. Singapore: Springer; 2018.
8- Logemann J. Evaluation and Treatment of Swallowing Disorders. Austin: Pro-ed; 1998.
9- Matsuo K, Palmer J. Anatomy and Physiology of Feeding and Swallowing - Normal and Abnormal. Physical Medicine and Rehabilitation Clinics of North America, 2008 Nov;19(4):691-707
10- Jiang E, Lyu Q, Lin F, You T, Jiang L. Hyoid-complex elevation and stimulation technique restores swallowing function in patients with lateral medullary syndrome: Two case reports. World Journal of Clinical Cases, 2020 Mart; 8(6):1142-1149
11- Miller J. Characteristics of the swallowing reflex induced by peripheral nerve and brainstem stimulation. Experimental Neurology, 1972; 34 (2):210-222.
12- Bautista G, Dutschmann M. Pontomedullary nuclei involved in the generation of sequential pharyngeal swallowing and concomitant protective laryngeal adduction in situ. Journal of Physiology, 2014 Jun; 592 (12):2605-2623.
13- Harris Warrick M. General principles of rhythmogenesis in central pattern generator networks. Progress in brain research, 2010; 187: 213-222.
14- Morquette P, Lavoie R, Fhima D, Lamoureux X, Verdier D, Kolta A. Generation of the masticatory central pattern and its modulation by sensory feedback. Progress in Neurobiology, 2012 Mart; 96(3):340-355.
15- Guertin A, Steuer I. Key central pattern generators of the spinal cord. Journal of Neuroscience Research, 2009: 87 (11): 2399-2405.
16- Abdala P, Rybak A, Smith C, Zoccal B, Machado H, St-John M, Paton F. Multiple pontomedullary mechanisms of respiratory rhythmogenesis. Respiratory Physiology & Neurobiology, 2009; 168:19-25.
17- Jean A. Brainstem control of swallowing: Neuronal network and cellular mechanisms. Physiological Reviews, 2001 Apr; 81(2): 929-969.
18- Im I, Jun J, Hwang S, Ko M. Swallowing outcomes in patients with subcortical stroke associated with lesions of the caudate nucleus and insula. Journal of International Medical Research. 2018;46(9):3552-3562.
19- Saylam C, Ucerler H, Orhan M, Cagli S, Zileli M. The relationship of the posterior inferior cerebellar artery to cranial nerves VII–XII. Clinical Anatomy. 2007;20(8):886-891.
20- Inamasu J, Nakae S, Kato Y, Hirose Y. Clinical Characteristics of Cerebellar Infarction Due to Arterial Dissection. Asian Journal of Neurosurgery, 2018;13(4): 995-1000.
21- Oshima F, Yokozeki M, Hamanaka M, Imai, K., Makino, M., Kimura, M., Fujiu-Kurachi, M. Prediction of Dysphagia Severity: An Investigation of the Dysphagia Patterns in Patients with Lateral Medullary Infarction. Internal medicine. 2013; 52(12):1325-1331.
22- Martin R, Goodyear B, Gati J, Menon R. Cerebral cortical representation of automatic and volitional swallowing in humans. Journal of Neuropsychology, 2001;85(2):928-950.
23- Martino R, Terrault N, Ezerzer F, Mikulis D, Diamant N. Dysphagia in a patient with lateral medullary syndrome: insight into the central control of swallowing. Gastroenerology, 2001;121(2);420-426.
24- Amri M, Car A. Projections from the medullary swallowing center to the hypoglossal motor nucleus: a neuroanatomical and electrophysiological study in sheep. Brain Research. 1988;441(1-2):119-126.
25- Aydogdu I, Ertekin C, Tarlaci S, Turman B, Kiylioglu N, Secil Y. Dysphagia in Lateral Medullary Infarction (Wallenberg’s Syndrome). Stroke. 2001;32(9):2081-2087.
26- Hinchey J, Shephard T, Furie K, Smith D, Wang D, Tonn S. Formal Dysphagia Screening Protocols Prevent Pneumonia. Stroke. 2005;36(9):1972-1976.
27- Trapl M, Enderle P, Nowotny M, Teuschl Y, Matz K, Dachenhausen A et al. Dysphagia Bedside Screening for Acute-Stroke Patients. Stroke. 2007;38(11):2948-2952.
28- Daniels S, Pathak S, Rosenbek J, Morgan R, Anderson J. Rapid Aspiration Screening for Suspected Stroke: Part 1: Development and validation. Archives of Physical Medicine and Rehabilitation. 2016;97(9):1440-1448.
29- Daniels S, Huckabee M, Gozdzikowska K. Dysphagia following stroke. San Diego: Plural Publishing; 2019.
30- ASHA. Knowledge and Skills Needed by Speech and Language Pathologist Providing Services to Individuals with Swalloving and/or Feeding Disorders. Preuzeto iz American Speech-Language-Hearing Association: asha.org. 2002.
31- Miles A, Zheng I, McLauchlan H, Huckabee M. Cough Reflex Testing in Dysphagia Following Stroke: A Randomized Controlled Trial. Journal of Clinical Medicine Research. 2013;5(3):222-223.
32- Desuter G. Oropharyngeal Dysphagia. Brussels: Springer International Publishing; 2019.
33- Jones C, Ciucci M, Hammer M, McCulloch T. A multisensor approach to improve manometric analysis of the upper esophageal sphincter. The Laryngoscope. 2015;126(3):657-664.
34- Martino R, McCulloch T. Therapeutic intervention in oropharyngeal dysphagia. Nature Reviews Gastroenterology & Hepatology. 2016;13(11):665-679.
35- Easterling C, Grande B, Kern M, Sears K, Shaker R. Attaining and Maintaining Isometric and Isokinetic Goals of the Shaker Exercise. Dysphagia. 2005;20(2):133-138.
36- Logemann J, Rademaker A, Pauloski B, Kelly A, Stangl-McBreen C, Antinoja J et al. A Randomized Study Comparing the Shaker Exercise with Traditional Therapy: A Preliminary Study. Dysphagia. 2009;24(4):403-411.
37- Veis S, Logemann J, Colangelo L. Effects of Three Techniques on Maximum Posterior Movement of the Tongue Base. Dysphagia. 2000;15(3):142-145.
38- Fujiu M, Logemann J. Effect of a Tongue-Holding Maneuver on Posterior Pharyngeal Wall Movement During Deglutition. American Journal of Speech-Language Pathology. 1996;5(1):23-30.
39- Lazarus C, Logemann J, Song C, Rademaker A, Kahrilas P. Effects of Voluntary Maneuvers on Tongue Base Function for Swallowing. Folia Phoniatrica et Logopaedica. 2002;54(4):171-176.
40- Kaatzke-McDonald M, Post E, Davis P. The effects of cold, touch, and chemical stimulation of the anterior faucial pillar on human swallowing. Dysphagia. 1996;11(3):198-206.
41- Humbert I, Michou E, MacRae P, Crujido L. Electrical Stimulation and Swallowing: How Much Do We Know? Seminars in Speech and Language. 2012;33(3):203-216.
42- Shaw G, Sechtem P, Searl J, Keller K, Rawi T, Dowdy E. Transcutaneous Neuromuscular Electrical Stimulation (VitalStim) Curative Therapy for Severe Dysphagia: Myth or Reality? Annals of Otology, Rhinology & Laryngology. 2007;116(1):36-44.
1- Srivastava M, Abeetha S, Srivastava S. Posterior inferiror cerebellar artery syndrome. International Journal of Healthcare and Biomedical Research, 2015;3 (2):76-79.
2- Pavlović S, Stefanović N, Vučetić R, Antić S, Čukuranović R, Arsić S. Anatomija centralnog nervnog sistema i čula. Niš: Sven; 2006.
3- Bian R, Choi I, Kim J, Han J, Lee S. Impaired Opening of the Upper Esophageal Sphincter in Patients with Medullary Infarctions. Dysphagia. 2008;24(2):238-245.
4- Sacco R, Freddo L, Bello A, Odel G, Onesti T, Mohr P. Wallenbergs lateral medullary syndrome. Clinical magnetic resonance imaging correlation. Archives of neurology. 1993; 50 (6):609-614
5- Daniels S. Neurological disorders affecting oral, pharyngeal swallowing. GI Motility. 2006.
6- Vuković M. Poremećaji komunikacije kod traumatskih oštećenja mozga. Beograd: Univerzitet u Beogradu – Fakultet za specijalnu edukaciju i rehabilitaciju; 2012.
7- Saitoh E, Pongpipatbaiboon K, Inamoto Y, Kagaya H. Dysphagia Evaluation and Treatment. Singapore: Springer; 2018.
8- Logemann J. Evaluation and Treatment of Swallowing Disorders. Austin: Pro-ed; 1998.
9- Matsuo K, Palmer J. Anatomy and Physiology of Feeding and Swallowing - Normal and Abnormal. Physical Medicine and Rehabilitation Clinics of North America, 2008 Nov;19(4):691-707
10- Jiang E, Lyu Q, Lin F, You T, Jiang L. Hyoid-complex elevation and stimulation technique restores swallowing function in patients with lateral medullary syndrome: Two case reports. World Journal of Clinical Cases, 2020 Mart; 8(6):1142-1149
11- Miller J. Characteristics of the swallowing reflex induced by peripheral nerve and brainstem stimulation. Experimental Neurology, 1972; 34 (2):210-222.
12- Bautista G, Dutschmann M. Pontomedullary nuclei involved in the generation of sequential pharyngeal swallowing and concomitant protective laryngeal adduction in situ. Journal of Physiology, 2014 Jun; 592 (12):2605-2623.
13- Harris Warrick M. General principles of rhythmogenesis in central pattern generator networks. Progress in brain research, 2010; 187: 213-222.
14- Morquette P, Lavoie R, Fhima D, Lamoureux X, Verdier D, Kolta A. Generation of the masticatory central pattern and its modulation by sensory feedback. Progress in Neurobiology, 2012 Mart; 96(3):340-355.
15- Guertin A, Steuer I. Key central pattern generators of the spinal cord. Journal of Neuroscience Research, 2009: 87 (11): 2399-2405.
16- Abdala P, Rybak A, Smith C, Zoccal B, Machado H, St-John M, Paton F. Multiple pontomedullary mechanisms of respiratory rhythmogenesis. Respiratory Physiology & Neurobiology, 2009; 168:19-25.
17- Jean A. Brainstem control of swallowing: Neuronal network and cellular mechanisms. Physiological Reviews, 2001 Apr; 81(2): 929-969.
18- Im I, Jun J, Hwang S, Ko M. Swallowing outcomes in patients with subcortical stroke associated with lesions of the caudate nucleus and insula. Journal of International Medical Research. 2018;46(9):3552-3562.
19- Saylam C, Ucerler H, Orhan M, Cagli S, Zileli M. The relationship of the posterior inferior cerebellar artery to cranial nerves VII–XII. Clinical Anatomy. 2007;20(8):886-891.
20- Inamasu J, Nakae S, Kato Y, Hirose Y. Clinical Characteristics of Cerebellar Infarction Due to Arterial Dissection. Asian Journal of Neurosurgery, 2018;13(4): 995-1000.
21- Oshima F, Yokozeki M, Hamanaka M, Imai, K., Makino, M., Kimura, M., Fujiu-Kurachi, M. Prediction of Dysphagia Severity: An Investigation of the Dysphagia Patterns in Patients with Lateral Medullary Infarction. Internal medicine. 2013; 52(12):1325-1331.
22- Martin R, Goodyear B, Gati J, Menon R. Cerebral cortical representation of automatic and volitional swallowing in humans. Journal of Neuropsychology, 2001;85(2):928-950.
23- Martino R, Terrault N, Ezerzer F, Mikulis D, Diamant N. Dysphagia in a patient with lateral medullary syndrome: insight into the central control of swallowing. Gastroenerology, 2001;121(2);420-426.
24- Amri M, Car A. Projections from the medullary swallowing center to the hypoglossal motor nucleus: a neuroanatomical and electrophysiological study in sheep. Brain Research. 1988;441(1-2):119-126.
25- Aydogdu I, Ertekin C, Tarlaci S, Turman B, Kiylioglu N, Secil Y. Dysphagia in Lateral Medullary Infarction (Wallenberg’s Syndrome). Stroke. 2001;32(9):2081-2087.
26- Hinchey J, Shephard T, Furie K, Smith D, Wang D, Tonn S. Formal Dysphagia Screening Protocols Prevent Pneumonia. Stroke. 2005;36(9):1972-1976.
27- Trapl M, Enderle P, Nowotny M, Teuschl Y, Matz K, Dachenhausen A et al. Dysphagia Bedside Screening for Acute-Stroke Patients. Stroke. 2007;38(11):2948-2952.
28- Daniels S, Pathak S, Rosenbek J, Morgan R, Anderson J. Rapid Aspiration Screening for Suspected Stroke: Part 1: Development and validation. Archives of Physical Medicine and Rehabilitation. 2016;97(9):1440-1448.
29- Daniels S, Huckabee M, Gozdzikowska K. Dysphagia following stroke. San Diego: Plural Publishing; 2019.
30- ASHA. Knowledge and Skills Needed by Speech and Language Pathologist Providing Services to Individuals with Swalloving and/or Feeding Disorders. Preuzeto iz American Speech-Language-Hearing Association: asha.org. 2002.
31- Miles A, Zheng I, McLauchlan H, Huckabee M. Cough Reflex Testing in Dysphagia Following Stroke: A Randomized Controlled Trial. Journal of Clinical Medicine Research. 2013;5(3):222-223.
32- Desuter G. Oropharyngeal Dysphagia. Brussels: Springer International Publishing; 2019.
33- Jones C, Ciucci M, Hammer M, McCulloch T. A multisensor approach to improve manometric analysis of the upper esophageal sphincter. The Laryngoscope. 2015;126(3):657-664.
34- Martino R, McCulloch T. Therapeutic intervention in oropharyngeal dysphagia. Nature Reviews Gastroenterology & Hepatology. 2016;13(11):665-679.
35- Easterling C, Grande B, Kern M, Sears K, Shaker R. Attaining and Maintaining Isometric and Isokinetic Goals of the Shaker Exercise. Dysphagia. 2005;20(2):133-138.
36- Logemann J, Rademaker A, Pauloski B, Kelly A, Stangl-McBreen C, Antinoja J et al. A Randomized Study Comparing the Shaker Exercise with Traditional Therapy: A Preliminary Study. Dysphagia. 2009;24(4):403-411.
37- Veis S, Logemann J, Colangelo L. Effects of Three Techniques on Maximum Posterior Movement of the Tongue Base. Dysphagia. 2000;15(3):142-145.
38- Fujiu M, Logemann J. Effect of a Tongue-Holding Maneuver on Posterior Pharyngeal Wall Movement During Deglutition. American Journal of Speech-Language Pathology. 1996;5(1):23-30.
39- Lazarus C, Logemann J, Song C, Rademaker A, Kahrilas P. Effects of Voluntary Maneuvers on Tongue Base Function for Swallowing. Folia Phoniatrica et Logopaedica. 2002;54(4):171-176.
40- Kaatzke-McDonald M, Post E, Davis P. The effects of cold, touch, and chemical stimulation of the anterior faucial pillar on human swallowing. Dysphagia. 1996;11(3):198-206.
41- Humbert I, Michou E, MacRae P, Crujido L. Electrical Stimulation and Swallowing: How Much Do We Know? Seminars in Speech and Language. 2012;33(3):203-216.
42- Shaw G, Sechtem P, Searl J, Keller K, Rawi T, Dowdy E. Transcutaneous Neuromuscular Electrical Stimulation (VitalStim) Curative Therapy for Severe Dysphagia: Myth or Reality? Annals of Otology, Rhinology & Laryngology. 2007;116(1):36-44.
Objavljeno
2025/12/21
Broj časopisa
Rubrika
Pregledni rad / Review article