TYPICAL SWALLOWING DISORDERS IN NEUROLOGIC POPULATIONS
     Jeri A. Logemann, Ph.D.

1.  Stroke (cortical and brainstem)

 • Delayed/absent reflex (aspiration before swallow)
 • Disrupted anterior-posterior tongue movement
 • Reduced pharyngeal contraction (aspiration after swallow)
 • Reduced laryngeal closure (usually brainstem strokes)
 • Cricopharyngeal dysfunction (aspiration after swallow)
2.  Lateral Medullary syndrome (Wallenberg’s)
 • Cricopharyngeal dysfunction
 • Reduced pharyngeal contraction
 • Reduced laryngeal closure (unilateral vocal cord paralysis)
3.  Head trauma
 • Delayed/absent reflex
 • Reduced tongue control
 • Reduced pharyngeal contraction
 • Cricopharyngeal dysfunction
 • Tracheoesophageal fistula
4.  Cerebral palsy
 • Reduced lingual control
 • Delayed reflex
 • Reduced pharyngeal contraction
5.  ALS
 • Reduced lingual control
 • Reduced pharyngeal contraction
 • Delayed reflex
 • Reduced laryngeal closure
 • Cricopharyngeal dysfunction
6.  Multiple Sclerosis
 • Any listed for ALS
 • Possible sensory changes
7.  Parkinson’s Disease
 • Abnormal anterior-posterior tongue motion (pumping motion)
 • Reduced pharyngeal contraction
 • Delayed reflex
 • Reduced laryngeal closure
 • Cricopharyngeal dysfunction
8.  Myasthenia Gravis
• Involvement of any cranial nerve musculature
• Fatigue - do fatigue study
9.  Myotonic dystrophy
 • Cricopharyngeal dysfunction
10. Oculopharyngeal Dystrophy
 • Reduced pharyngeal contraction