Investigation of neurogenic dysphagia in commonly seen neurological diseases

Year 2025, Volume: 30 Issue: 1, 150 - 161, 29.01.2025

Müberra Tanrıverdi , Senanur Düzenli , Merve Sevinç Gündüz , Ayça Arslantürk , Ayşenur Erekdağ

https://doi.org/10.21673/anadoluklin.1432672

Abstract

Neurological disorders lead to varying degrees of impairment in the functions of vital swallowing structures, such as the cortex, cerebellum, brainstem, cranial nerves, and muscles. Neurogenic dysphagia is observed in approximately 50% of common neurological disorders such as stroke, multiple sclerosis, and Parkinson’s disease. Although the pathophysiology and course of the disease vary, dysphagia may occur at any stage of swallowing, including oral preparation, oral, pharyngeal, and esophageal phases. Neurogenic dysphagia ranks among the top symptoms that restrict patients’ independence in daily life activities, reduce their quality of life and increase morbidity and mortality rates. Despite being a prevalent and highly impactful symptom among patients, neurogenic dysphagia can go unnoticed among the multiple symptoms experienced by neurological disorders due to their nature. It is important to be aware of disease-specific risk factors for the early detection of neurogenic dysphagia. Overlooked dysphagia can lead to complications such as aspiration pneumonia, dehydration, malnutrition, and weight loss. Among these complications, aspiration pneumonia is the most common, requiring attention due to its recurrent hospitalizations, inpatient treatment, and high healthcare costs. Many patients exhibit common neurogenic dysphagia symptoms such as drinking liquids in small sips, cutting solid foods into small pieces, decreased appetite, and prolonged meal times. The aim of this study is to examine various aspects of neurogenic dysphagia in different neurological disorders, including its etiology, risk factors, symptoms, and prevalence.

Keywords

Demantia, multiple sclerosis, stroke, swallowing disorders

Sık görülen nörolojik hastalıklarda nörojenik disfajinin araştırılması

Abstract

Nörolojik hastalıklar yutma için hayati öneme sahip korteks, serebellum, beyin sapı, kranial sinirler ve kaslar gibi yapıların fonksiyonlarında çeşitli derecelerde bozulmaya yol açar. Nörojenik disfaji; inme, multiple skleroz, parkinson gibi yaygın görülen nörolojik hastalıkların yaklaşık %50’sinde görülür. Hastalığın patofizyolojisi ve seyrine göre değişmekle birlikte yutmanın oral hazırlık, oral, faringeal ve özefageal fazlarının herhangi birinde disfaji ortaya çıkabilir. Nörojenik disfaji bu hastaların günlük yaşam aktivitelerindeki bağımsızlıklarını kısıtlayan, yaşam kalitelerini azaltan ve morbidite, mortalite oranlarını arttıran semptomlar arasında ilk sıralardadır. Nörojenik disfaji, yaygın görülen ve hastaları oldukça olumsuz etkileyen bir semptom olmasına rağmen nörolojik hastalıkların doğası gereği hastanın yaşadığı çoklu semptomlar arasında gözden kaçabilmektedir. Nörojenik disfajinin erken tespiti için hastalıklara özel risk faktörlerinin iyi bilinmesi önemlidir. Gözden kaçırılan disfaji ilerleyen dönemlerde aspirasyon pnömonisi, dehidrasyon, malnütrisyon, kilo kaybı gibi komplikasyonların oluşmasına neden olur. Bu komplikasyonlar arasında en sık görülen aspirasyon pnömonisi; tekrarlı hastane başvuruları, yatarak tedavi ve yüksek sağlık maliyetleri gerektirmesi nedeniyle dikkat edilmesi gereken bir durumdur. Hastaların birçoğu sıvıları çok yudumda içme, katı gıdaları küçük lokmalara bölme, iştahta azalma, yemek süresinin uzaması gibi ortak nörojenik disfaji belirtilerine sahiptir. Bu çalışmanın amacı farklı nörolojik hastalıklarda görülen nörojenik disfajinin oluşma mekanizması, risk faktörleri, semptomları ve prevelansı gibi yönlerini incelemektir.

Keywords

Demans, inme, multipl skleroz, yutma bozuklukları

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