Management of Dysphagia in Acquired and Progressive Neurologic Conditions.
Michelle Ciucci, Jesse Hoffmeister, Karen Wheeler-Hegland
PMID 31158904WHAT IT FOUND
Patients with progressive neurologic disease often under-report swallowing problems because sensory perception degrades.
Clinicians should rely on imaging rather than patient self-report, and verify any compensatory maneuvers or diet changes with instrumented evaluation.
Key findings
01Sensory degradation in conditions like Parkinson's disease leads patients to under-report dysphagia symptoms, meaning a lack of patient complaint does not indicate normal swallowing.
02Compensatory maneuvers and diet modifications should be verified with instrumented evaluation (such as MBS) rather than assumed effective based on clinical observation alone.
03Treatment goals for progressive diseases often shift from safety to comfort, requiring early communication about non-oral feeding options before respiratory status declines.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This is a narrative review and does not present new experimental data or a systematic search of the literature. Recommendations are based on expert opinion and existing studies, which may vary in quality. The review covers a broad range of neurologic conditions, so specific disease nuances may be generalized.
Declared interests
None declared.
The easy way to misread this
Do not assume a patient is swallowing safely just because they do not report difficulty or show overt signs of distress. The paper states that sensory perception degrades in these conditions, leading to under-reporting, so a lack of complaint is not evidence of normal function.