Four-quadrant facial function in dysphagic patients after stroke and in healthy controls.
This study aims to examine any motility disturbance in any quadrant of the face other than the quadrant innervated by the lower facial nerve contralateral to the cortical lesion after stroke. Thirty-one stroke-afflicted patients with subjective dysphagia, consecutively referred to a swallowing centre, were investigated with a facial activity test (FAT) in all four facial quadrants and with a swallowing capacity test (SCT). Fifteen healthy adult participants served as FAT controls. Sixteen patients were judged to have a central facial palsy (FP) according to the referring physician, but all 31 patients had a pathological FAT in the lower quadrant contralateral to the cortical lesion. Simultaneous pathology in all four quadrants was observed in 52% of stroke-afflicted patients with dysphagia; some pathology in the left or right upper quadrant was observed in 74%. Dysfunction in multiple facial quadrants was independent of the time interval between stroke and study inclusion. All patients except two had a pathological SCT. All the controls had normal activity in all facial quadrants. In summary the majority of poststroke patients with dysphagia have subclinical orofacial motor dysfunction in three or four facial quadrants as assessed with a FAT. However, whether subclinical orofacial motor dysfunction can be present in stroke-afflicted patients without dysphagia is unknown.
Department of Otorhinolaryngology, Speech & Swallowing Centre, Hudiksvall Hospital, 824 81 Hudiksvall, Sweden ; Research & Development Centre, Uppsala University/Gävleborg, 751 85 Uppsala, Sweden.
Mary
0000-0003-3923-5475
M
Hägg
Department of Otorhinolaryngology, Linköping University, 581 85 Linköping, Sweden.
Lita
L
Tibbling