title: Comparison of dysphagia outcomes between rostral and caudal lateral medullary infarct patients.
abstract: OBJECTIVE
  A detailed knowledge of dysphagia outcomes in lateral medullary infarct (LMI) patients would enable proper establishment of swallowing therapy goals and strategies. However, little is known about the impact of infarct location on dysphagia outcomes in patients with LMI.
  
  
  METHODS
  Twenty patients with rostral LMI (rostral group) and 20 patients with caudal LMI (caudal group) participated in the study. All patients underwent swallowing therapy, which included compensatory treatments and strengthening exercises, for >3 months. Dysphagia evaluation was performed twice (during the subacute stage and six months after stroke onset) using videofluoroscopic swallowing studies. Dysphagia degree was assessed using the functional dysphagia scale (FDS), the penetration-aspiration scale (PAS) and the American Speech-Language-Hearing Association (ASHA) National Outcome Measurement System (NOMS) swallowing scale.
  
  
  RESULTS
  In the subacute stage, the rostral group had significantly higher FDS and PAS scores and a significantly lower ASHA NOMS score than the caudal group. Patients from both groups showed significant improvement from the initial evaluation to the six-month evaluation. There were no significant differences in these scale scores between the two groups at the six-month evaluation.
  
  
  CONCLUSIONS
  In the subacute stage, patients in the rostral group had more severe dysphagia than those in the caudal group. Dysphagia improved in both groups after 3-6 months of swallowing therapy. At six months after onset, there were no significant differences in dysphagia severity between the two groups. Recovery from dysphagia after LMI was observed regardless of the infarct location.
authors.affiliation: a Asan Medical Center, Department of Physical Medicine and Rehabilitation , University of Ulsan College of Medicine , Seoul , Republic of Korea.
authors.forename: Min Ho
authors.initials: MH
authors.lastname: Chun
authors.affiliation: b Department of Physical Medicine and Rehabilitation , Eson Hospital , Ulsan , Republic of Korea.
authors.forename: Daeha
authors.initials: D
authors.lastname: Kim
authors.affiliation: c Department of Physical Medicine and Rehabilitation , College of Medicine, Yeungnam University , Daegu , Republic of Korea.
authors.forename: Min Cheol
authors.initials: MC
authors.lastname: Chang
mesh_terms: D000368:Aged; D020526:Brain Stem Infarctions / Q000150:complications / Q000473:pathology*; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008526:Medulla Oblongata / Q000473:pathology*; D008875:Middle Aged; D000066530:Neurological Rehabilitation; D017063:Outcome Assessment, Health Care; D012720:Severity of Illness Index
keywords: Dysphagia; lateral medullary infarct; lesion location; prognosis; videofluoroscopic swallowing study