Efficacy of BoNT-A and swallowing treatment for oropharyngeal dysphagia recovery in a patient with Lateral Medullary Syndrome:

Irene Battel, Isabella Koch, Federica Biddau, Carla Carollo, Francesco Piccione, Francesca Meneghello, Antonio Merico, Katie Palmer, Rosario Marchese-Ragona

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BACKGROUND: Wallenberg’s syndrome (WS) is known as posterior inferior cerebellar artery syndrome. Dysphagia has been reported from 51% to 94% of the patients, ranging from mild to severe.
CASE REPORT: We reported a case of a patient (male; 52 years) with WS. MRI showed an intense hypodense area in the dorsolateral part of the ponto-medullary junction. The clinical signs were severe dysphagia, fed by PEG (FOIS 1; PAS 7), sialorrhea, trismus and ataxia.
CLINICAL REHABILITATION IMPACT: Dysphagia was treated by botulinum toxin type-A (BoNT-A), which was injected into the parotid and submandibular salivary glands, temporalis and masseter muscles, cricopharyngeal muscle associated with specific swallowing exercise and food trails. The 3-months follow-up showed significant saliva reduction and improvement of swallowing to from PEG feeding to consistent oral intake of food (FOIS 3, PAS 5). The treatment with BoNT-A combined with swallowing rehabilitation was fundamental in order to restore the swallowing functions.

KEY WORDS: Lateral medullary syndrome - Botulinum toxins, type A - Deglutition disorders - Sialorrhea
Original languageItalian
Pages (from-to)798-801
Number of pages4
JournalEuropean Journal of Physical and Rehabilitation Medicine
Issue number(5)
Publication statusPublished - Oct 7 2017

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