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Table 3 Endoscopic phenotypes of neurogenic dysphagia [65]

From: Diagnosis and treatment of neurogenic dysphagia – S1 guideline of the German Society of Neurology

Main findings

Neurological diseases

Peripheral

Central

I) Premature spillage

Early-stage ALS

Early-stage ALS, early-stage PSP, frontotemporal dementia, SPG7-HSP, acute stroke*

II) Delayed swallow reflex

 

Acute stroke*

III) Impaired pharyngeal bolus clearance (residue in valleculae >>> residue in piriform sinus)

Bulbospinal muscular atrophy, myotonic dystrophy type II, (critical illness neuropathy/myopathy,) early stage ALS

Early ALS, early-stage PD

IV) Impaired opening of upper oesophageal sphincter (residue in piriform sinus >>> residue in valleculae)

Inclusion body myositis (IBM)

Dorsolateral medulla oblongata infarction

V) Complex pathology (combination of I-IV, at least 2 equivalent patterns)

Severe myasthenia gravis, end-stage ALS, (GBS), myotonic dystrophy type I

End-stage ALS, advanced stages of PD and PSP

VI) Extrapyramidal motor impairment (one out of I-IV) plus movement disorder

Neuroleptic-induced dysphagia, PD, MSA, Huntington’s disease

VII) Fatigable oropharyngeal dysphagia (one out of I-IV plus swallowing fatigability)

Myasthenia gravis

(PD, ALS)

  1. *All stroke locations apart from strokes confined to the dorsolateral medulla oblongata