[Diagnosis and treatment of neurogenic dysphagia after acute ischemic stroke].

Abstract

AIM:

To determine the efficacy of post-stroke dysphagia treatment by choline alfoscerate (ChA), succinate combination (SC), and their combination with sip, larynx, and swallowing exercises.

MATERIAL AND METHODS:

Four groups of primary ischemic stroke (IS) patients (n=80; 62±0.2 y.o., verified by MRI), including controls, admitted to Stroke Unit 24 h after stroke in the area of RAM (29.5%), and LAM (70.5%), were studied. Basic therapy was provided according to National Stroke Treatment Recommendations, treated groups received ChA 14 mg/kg (2st gr.), SC 0.5 mg/kg (3nd gr.), combination of two compounds (3d gr.). Controls (4th gr.) received placebo. Pharmacological treatment was provided for 10 days with continuation by oral administration. Dysphagia was measured semi-quantitively by MASA scale, three scale determinants were measured on admission, on 5 and 13 days of stay in the hospital.

RESULTS AND CONCLUSION:

The differences were significant and observed on the 5th day of treatment. ChA mostly improved sip control, and larynx movements (38% above controls; p<0.01), while SC improved the closure of vocal cords (55% above controls; p<0.01). This may reflect the differences in synaptic control of these functions. Combined treatment was more effective than monotherapy: 15% above ChA, and 21% above SC for swallowing function (p=0.01); 33 and 22% for vocal closure, 37% (p=0.05) and 76% (p=0.01) for larynx movement, which may be due to synergism between two medications. Therefore, sip, larynx, and swallowing exercises with pharmacological support of ChA and SC ameliorated dysphagia after IS.

• Authors: I N Balashova, N P Vanchakova, V V Afanasiev, E R Barantzevich, E L Pugacheva, K V Golikov
• Journal: Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova (Zh Nevrol Psikhiatr Im S S Korsakova) 2018 Vol. 118 Issue 12. Vyp. 2 Pg. 64-69 ISSN: 1997-7298 [Print] Russia (Federation)
• Vernacular Title: Diagnostika i lechenie neĭrogennoĭ disfagii u bol'nykh, perenesshikh ostryĭ karotidnyĭ ishemicheskiĭ insul't.
• PMID: 30830119 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Glycerylphosphorylcholine
• Succinic Acid

Topics

• Brain Ischemia (complications)
• Deglutition
• Deglutition Disorders (diagnosis, drug therapy, etiology)
• Glycerylphosphorylcholine (therapeutic use)
• Humans
• Stroke (complications)
• Succinic Acid (therapeutic use)