2008 Volume 30 Issue 4 Pages 604-609
Purpose: To investigate the influences of stroke recurrence and aspiration pneumonia during the acute phase of swallowing rehabilitation for lateral medullary syndrome (LMS). Subjects and Methods: Twenty consecutive LMS patients were selected retrospectively and divided into two groups: (1) the untreated group (10 cases) who had not undergone swallowing rehabilitation before the year 2004 when we had began swallowing rehabilitation, and (2)the treated group (10 cases) who had undergone swallowing rehabilitation after 2004. These two groups were compared for age, treatment response time, risk of stroke recurrence/aspiration pneumonia, length of hospitalization, and outcome. Results: The mean age of the untreated group was 64 years (M/F, 9/1; ischemia/hemorrhage, 8/2). The mean age of the treated group was 60 years (M/F, 8/2; ischemia/hemorrhage, 10/0). The term of fast in the treated group (2.3 days) was shorter than that in the untreated group (10.9 days; p=0.005). The gait ability was the same between the two groups at discharge. The treated group demonstrated better recovery of swallowing function (deglutition food evaluation of Fujishima) than the untreated group at discharge from our hospital. However, there were no differences of swallowing function between the two groups at the final function. The occurrence of aspiration pneumonia in the treated group (3 cases) was less than that in the untreated group (6 cases; p=0.04). Three cases in each group of recurrence did not correlate with swallowing rehabilitation for dysphagia during the acute stage, since many patients had recurrent stroke when they were removed from their total bed-rest. Conclusion: The approach of emproging swallowing rehabilitation in the acute phase of LMS did not influence the stroke recurrence. Instead, it appeared to promote a faster recovery of swallowing function, and to prevent aspiration pneumonia.
