Abstract
Fifteen cases of dysphagia with acute onset were clinically investigated. Radiocinephotography and electromyography were applied to all cases. The author tried to classify the cases into two categories, central lesions and periferal lesions. The onset of dysphagia with central lesion ranged from five days to two weeks, and the duration of dysphagia was rather long. On the other hand, the onset of dysphagia with peripheral lesion ranged less than three days, mostly within twenty-four hours and the duration of dysphagia was short. Healing process of dysphagia with peripheral lesion was also quick, within seven days.
Cinephotographic observation revealed that dysphagia with central lesion was markedly demonstrated in the first stage (oropharyngeal stage) and coordination of muscles of deglutition was much disturbed.
Electromyographic observation showed interesting results as follows; The pattern of deglutition of the patient with central lesion was much irregular and showed disturbance in coordination of swallowing muscles. Continuous swallowing was difficult and resulted in misdeglutition. However, the denervation potentials were not observed at all. Amplitudes of electromyogram showed generally low voltage.
The swallowing pattern of the patient with local lesions was regular and each muscle of deglutition contracted in order timewise. Coordination of muscles was good and the bolus passed easily the entrance of esophagus. Continuous swallowing was possible. The liquid, however, was rather difficult to be swallowed in rapidly repeated pattern. The denervation potentials were well observed if seen within two weeks of onset. High voltages and fasciculation were often observed as signs of renervation.
Generally speaking, the central lesion accompanies the other signs and symptomes than dysphagia, and takes longer time of healing. On the other hand, peripheral lesion does not associates with the other signs nor symptomes than dysphagia and has healed within two weeks mostly.
