Abstract
Dynamics of swallowing was investigated in six patients with cerebro-vascular disease (CVD). The data were obtained from simultaneous recordings for four four-channel electromyography and fluoroscopic X-ray video-recording. Three of the patients had scattered lesions in the brain stem and cerebrum (scattered type) and the other three had a lesion localized in the medulla (medullar type). The results are summarized as follows: 1. In the scattered type, difficulty in swallowing is primarily caused by hesitation and slow movements in the oral stage. There were also weakness of the muscular activities in the pharyngeal stage, resulting in a slight disturbance in transporting the bolus through the pharynx. Incoordination of the passage of the bolus and the musclular kinesiology in the pharyngeal stage accelerates the problem, causing aspiration when the larynx goesdown. 2. In the medullar type, difficulty in swallowing is primarily caused by abnormal kinesiology of the muscles during the oral stage and severe disturbance of the reflex mechanism for the pharyngeal stage. As a result, the bolus do not enter the esophagus at all.
