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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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European Journal of Physical and Rehabilitation Medicine 2017 Mar 06

DOI: 10.23736/S1973-9087.17.04499-9

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

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

Irene BATTEL 1, Isabella KOCH 1, Federica BIDDAU 1, Carla CAROLLO 1, Francesco PICCIONE 1, Francesca MENEGHELLO 1, Merico ANTONIO 1, Katie PALMER 1, Rosario MARCHESE RAGONA 2

1 Fondazione Ospedale di Neuroriabilitazione IRCCS San Camillo, Venice, Italy; 2 Dipartimento Strutturale Aziendale Neuroscienze e Organi di Senso, Azienda Ospedaliera di Padova, Padova, Italy


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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 PRESENTATION: We reported a case of a patient (Male; 52yrs) 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 tipe 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: Lateralmedullary syndrome (LMS) - Wallenberg's syndrome (WS) - Botulinum toxin tipe A (BoNT-A) - Dysphagia - Swallowing rehabilitation - Sialorrhea

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Cite this article as

Battel I, Koch I, Biddau F, Carollo C, Piccione F, Meneghello F, et al. Efficacy of BoNT-A and swallowing treatment for oropharyngeal dysphagia recovery in a patient with Lateral Medullary Syndrome: a case study. Eur J Phys Rehabil Med 2017 Mar 06. DOI: 10.23736/S1973-9087.17.04499-9 

Corresponding author e-mail

irene.battel@ospedalesancamillo.net