2024 Volume 28 Issue 3 Pages 176-182
The decreased laryngopharyngeal sensation in Wallenberg’s syndrome is one of the factors that cause a delay in the initiation of oral intake, and training using ice chip swallowing or small amounts of water may not be indicated in severe cases or early onset cases. To the best of our knowledge, there are not many useful direct swallowing training methods.
In the present study, a patient with Wallenberg’s syndrome, who presented with dysphagia and failure of opening of the upper esophageal sphincter (UES), received feeding training using frozen jelly slices (hereafter “frozen jelly training”) in the early stage of the disease, and the training was effective in improving the patient’s swallowing function.
Frozen jelly training is a unique training method in our hospital for severely dysphagic patients with inadequate or delayed swallowing reflex induction and difficulty in code 0j or code 0t oral ingestion. Frozen jelly training has been reported to be useful for treating delayed swallowing reflex elicitation in patients with pseudobulbar palsy, but it was also useful in patients with Wallenberg’s syndrome in whom it was difficult to elicit the swallowing reflex. It is possible that the increased sensory input provided by the frozen jelly was useful in enhancing the swallowing reflex via the nucleus tractus solitarii (central pattern generator) and nucleus ambiguus. Direct training by unilateral swallowing, rotating the neck before swallowing in a sitting position, and balloon training were useful for defective opening of the UES.
In patients with Wallenberg’s syndrome, swallowing function tests and appropriate training according to symptoms from early onset may contribute to the prevention of aspiration pneumonia and early recovery of swallowing functions, and may prevent a delay in the initiation of oral intake.
