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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 October;53(5):798-801

DOI: 10.23736/S1973-9087.17.04499-9

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Efficacy of botulinum toxin type-A and swallowing treatment for oropharyngeal dysphagia recovery in a patient with lateral medullary syndrome

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

1 Neuroriabilitation Hospital Foundation IRCCS San Camillo, Venice, Italy; 2 Department of Neurosciences and Sense Organs, AO Padua, Padua, 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 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

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Publication History

Issue published online: October 31, 2017
Article first published online: March 6, 2017
Manuscript accepted: February 28, 2017
Manuscript revised: February 8, 2017
Manuscript received: September 21, 2016

Cite this article as

Battel I, Koch I, Biddau F, Carollo C, Piccione F, Meneghello F, et al. Efficacy of botulinum toxin type-A and swallowing treatment for oropharyngeal dysphagia recovery in a patient with lateral medullary syndrome. Eur J Phys Rehabil Med 2017;53:798-801. DOI: 10.23736/S1973-9087.17.04499-9

Corresponding author e-mail

irene.battel@ospedalesancamillo.net