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POST-STROKE DYSPHAGIA: A TOPICAL DIAGNOSIS = ПОСТІНСУЛЬТНА ДИСФАГІЯ: ТОПІЧНИЙ ДІАГНОЗ
No full textPalamarchuk A. L. POST-STROKE DYSPHAGIA: A TOPICAL DIAGNOSIS = ПОСТІНСУЛЬТНА ДИСФАГІЯ: ТОПІЧНИЙ ДІАГНОЗ. ВІСНИК МОРСЬКОЇ МЕДИЦИНИ. 2020;2(87):122-126. ISSN 0049-6804.
DOI http://dx.doi.org/10.5281/zenodo.3976570
http://www.herald.com.ua
УДК 616.321-008.17-02:616.831-005.1/.4]-079.2
DOI http://dx.doi.org/10.5281/zenodo.3976570
ПОСТІНСУЛЬТНА ДИСФАГІЯ: ТОПІЧНИЙ ДІАГНОЗ
А. Л. Паламарчук
Київський медичний університет
Summary. Palamarchuk A. L. POST-STROKE DYSPHAGIA: A TOPICAL DIAGNOSIS. - Kyiv Medical University, Ukraine; e-mail: [email protected]. Swallowing dysfunction (dysphagia) is common and disabling after acute stroke, but its impact on long-term prognosis for potential complications and the recovery from swallowing dysfunction remain uncertain. The aim of the study is to assess the basic patterns in the occurrence of post-stroke dysphagia depending on the location of the ischemia. It is shown that bilateral lesions of the cortico-nuclear pathways with the development of pseudobulbar syndrome, right-sided localization of stroke involving cortical and subcortical structures with afferent disorganization and left-sided strokes with the development of aphasia and oral apraxia, as well as stroke can be considered. The pathogenesis of post-stroke dysphagia is associated with the development of bulbar syndrome in 13.5% of cases, pseudobulbar syndrome - in 31.2% and swallowing apraxia syndrome - in 55.3%. Topical diagnosis of post-stroke dysphagia requires neuroimaging and functional tests as soon as possible after the first signs of stroke.
Key words: post-stroke dysphagia, topical diagnosis, neuroanatomy, neurophysiology
Реферат. Паламарчук А. Л. ПОСТИНСУЛЬТНАЯ ДИСФАГИЯ: ТОПИЧЕСКИЙ ДИАГНОЗ. Цель исследования: оценить основные закономерности возникновения постинсультных дисфагий в зависимости от локализации очага ишемии. Показано, что двустороннее поражение корково-ядерных путей с развитием псевдобульбарного синдрома, правосторонняя локализация инсульта с вовлечением корковых и подкорковых структур с афферентной дезорганизацией и левостороннего инсульта с развитием афазии и оральной апраксии а также инсультные поражения в мозжечке могут считаться основными причинами возникновения ПИД. Патогенез постинсультных дисфагии связан с развитием бульбарного синдрома в 13,5% случаев, псевдобульбарного синдрома - в 31,2% и синдрома апраксии глотания - в 55,3%. Топическая диагностика постинсультных дисфагии требует проведения нейровизуализационных исследований и функциональных тестов в возможно короткий срок после первых проявлений инсульта.
Ключевые слова: постинсультная дисфагия, топическая диагностика, нейроанатомия, нейрофизиологи
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