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Open AccessCase Report

Therapy of Dysphagia by Prolonged Pharyngeal Electrical Stimulation (Phagenyx) in a Patient with Brainstem Infarction

1
Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria
2
Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria
3
Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, 2130 Mistelbach, Austria
4
Department of Neurology, Klinikum rechts der Isar, Technische Universität München, 81675 München, Germany
5
Karl Landsteiner Institute for Neurorehabilitation and Space Neurology, 5020 Salzburg, Austria
*
Author to whom correspondence should be addressed.
Brain Sci. 2020, 10(5), 256; https://doi.org/10.3390/brainsci10050256
Received: 9 April 2020 / Revised: 24 April 2020 / Accepted: 26 April 2020 / Published: 28 April 2020
(This article belongs to the Special Issue Stroke Treatments and Therapies)
Dysphagia after stroke impacts quality of life and is a risk factor for respiratory infections. Patients frequently require prophylactic measures including nasogastric tube or percutaneous endoscopic gastrostomy. Until recently, therapy for dysphagia was limited to training with a speech and language specialist. Intraluminal pharyngeal electrical stimulation (PES) is a new technique that stimulates the pharyngeal sensory afferents to the higher swallowing center in cortex. The clinical trials published to date involved stimulation for 10 minutes over three days. We present a case of brainstem infarction with severe dysphagia in a 53-year-old woman with preserved cognitive functions. For airway protection, she had a surgical tracheotomy. The initial swallowing training achieved slight improvements, but stagnated after three months so PES was tried. Under good PES tube tolerance, a prolonged and repeated stimulation protocol was administered, with the main purpose of relieving her of the tracheal tube. Although the swallowing improved, she stayed tube-dependent with minimal attempts with puréed food during therapy, and could not be decannulated. Further studies are required to assess the value of this promising approach for the treatment of dysphagia. View Full-Text
Keywords: dysphagia; ischemic stroke; pharyngeal electrical stimulation; treatment; rehabilitation dysphagia; ischemic stroke; pharyngeal electrical stimulation; treatment; rehabilitation
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Florea, C.; Bräumann, C.; Mussger, C.; Leis, S.; Hauer, L.; Sellner, J.; Golaszewski, S.M. Therapy of Dysphagia by Prolonged Pharyngeal Electrical Stimulation (Phagenyx) in a Patient with Brainstem Infarction. Brain Sci. 2020, 10, 256.

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