Electrophysiologic Evaluation of Neurogenic Dysphagia: Mechanisms, Methods, and Clinical Insights
Makaleler > Tam Makale · 2025
Yazarlar: Şeyma AYKAÇ, İbrahim AYDOĞDU, Cumhur Ertekin
Neurological Sciences and Neurophysiology, Uluslararası, Wos, 2025, cilt 42, ss 84-93
Özet
A BSTRACT Swallowing is a complex and finely regulated sensorimotor function involving the synchronized activity of more than 30 muscles and several cranial nerves. Neurogenic dysphagia, which most frequently affects the oropharyngeal phase, arises from lesions located anywhere along the swallowing pathway – from cortical centers to peripheral neuromuscular structures. If unrecognized, it may result in serious complications such as aspiration pneumonia, dehydration, and malnutrition. Electrophysiologic techniques offer a non-invasive, repeatable, and physiologically meaningful alternative for the functional evaluation of swallowing, especially in patients with neurologic conditions. This review summarizes the neuroanatomic and physiologic foundations of swallowing and introduces the main electrophysiologic tools: submental surface electromyography (SM-EMG), cricopharyngeal EMG (CP-EMG), laryngeal motion sensors, and nasal airflow monitoring. Three feasible protocols in daily practice and clinical research – single bolus analysis, dysphagia limit (DL), and sequential water swallowing – are discussed, each assessing different aspects of swallow initiation, capacity, and swallow–respiration coordination. These methods have demonstrated diagnostic utility in various neurologic diseases, including amyotrophic lateral sclerosis, Parkinson’s disease, stroke, neuromuscular disorders, multiple sclerosis, and Alzheimer’s disease. In addition, polygraphic monitoring of spontaneous swallowing provides further insight, particularly in neurodegenerative and brainstem disorders. In conclusion, electrophysiologic assessment offers a practical and clinically relevant complement to traditional diagnostic approaches in the evaluation and management of neurogenic dysphagia.