Clinical case: A patient with severe post-stroke dysphagia and sialorrhea
https://doi.org/10.21518/ms2025-526
Abstract
Stroke is a major cause of disability for adults. Stroke-related disability can be categorized into motor and non-motor impairments. Motor impairments, such as hemiplegia, are the most noticeable sequelae. However, non-motor impairments, such as cognitive deficits, speech impairment, visual disorders, dysphagia, mood disorders, and pain can cause far greater decreases in quality of life. This article presents a case of patient S., 59 years old, admitted to the Rehabilitation Department for patients with central nervous system dysfunction. The patient was hospitalized one month after recurrent basilar artery ischemic stroke, which resulted in the severe dysarthria, severe dysphagia, right hemiplegia, and hemihypesthesia. Due to severe dysphagia and failure of food passage from the mouth to the stomach, the patient had an existing NG tube in place when he was admitted to the Rehabilitation Department. On the fifth day of admission to the Rehabilitation Department, the patient underwent ultrasonography-guided Botulinum neurotoxin type A (BoNT-A) injections into the submandibular and parotid glands bilaterally. As a result of the comprehensive treatment (speech and physical rehabilitation, botulinum therapy, drug therapy), the patient showed improvement in swallowing function: an increase in the swallowed bolus volume, a decrease in the number of choking sensations when swallowing, enhancement of the cough reflex and restoration of the pharyngeal reflex, ability to spontaneously cough up mucus, improvement of soft palate phonation, reduction in dysarthria severity, and expansion of his motor activities.
About the Authors
N. V. Pizova
Yaroslavl State Medical University
Russian Federation
Russian Federation
Nataliia V. Pizova, Dr. Sci. (Med.), Professor of the Department of Nervous Diseases with Medical Genetics and Neurosurgery
5, Revolutsionnaya St., Yaroslavl, 150000
T. V. Kolotilova
Clinical Hospital No. 2
Russian Federation
Russian Federation
Tatyana V. Kolotilova, Neurologist of the Department of Medical Rehabilitation of Patients with Central Nervous System Disorders
39, Suzdal Shosse, Yaroslavl, 150030
N. A. Pizov
Clinical Hospital No. 2
Russian Federation
Russian Federation
Nikolai А. Pizov, Head of the Department of Medical Rehabilitation of Patients with Central Nervous System Disorders
39, Suzdal Shosse, Yaroslavl, 150030
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For citations:
Pizova NV, Kolotilova TV, Pizov NA. Clinical case: A patient with severe post-stroke dysphagia and sialorrhea. Meditsinskiy sovet = Medical Council. 2025;(22):210-215. (In Russ.) https://doi.org/10.21518/ms2025-526
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