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Semin Speech Lang 2019; 40(03): 203-212
DOI: 10.1055/s-0039-1688981
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Management of Dysphagia in Acquired and Progressive Neurologic Conditions

Michelle Ciucci
1   Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin
2   Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin
3   Neuroscience Training Program, University of Wisconsin-Madison, Madison, Wisconsin
,
Jesse Hoffmeister
1   Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin
2   Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin
,
Karen Wheeler-Hegland
4   Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, Florida
› Author Affiliations
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Publication History

Publication Date:
03 June 2019 (online)

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Abstract

As the act of deglutition involves much of the central and peripheral nervous systems, neurologic disease can affect swallowing behaviors ranging from mild to profound in severity. The key in working with neurogenic dysphagia is to have a solid foundation in normal swallowing processes, including neural control. Within this framework, then, understanding how the neurologic condition affects neural control will guide hypothesis-based assessment and evidence-based treatment. The purpose of this article is to provide an overview of evaluation and treatment of neurogenic dysphagia in adult populations as well to propose assessment of co-occurring speech, language, and airway compromise. Furthermore, it is vital to be familiar with ethical decision making and end-of-life issues. Continuing education in the form of research articles, conferences, and professional discussion boards is useful in maintaining a high level of service delivery. Whenever possible, an inter- or transdisciplinary approach is recommended.

Keywords

dysphagia - neurologic disease - parkinsonism - multiple sclerosis - motor neuron disease

Financial Disclosure

M.C. receives salary support from the University of Wisconsin. She receives grant funding from the National Institutes of Health, NIDCD (5R01DC014358-04; Nadine's R01DC008149-10; Lever 5R21DC016071-02) and is a trainer on NIDCD T32 DC009401.


J.H. is a predoctoral trainee in the Voice Research Training Program at the University of Wisconsin-Madison, NIH, NIDCD T32 DC009401.


K.W.-H. receives salary support from the University of Florida. She receives grant funding from the National Institutes of Health, SPARC Initiative (OT2OD023854), and NICHD (1R01HD091658-01A1; K.W.-H, PI), and the Michael J. Fox Foundation (5442528-01, M. Troche, PI)