[Dysphagia] swallow apraxia

[smhjr at surfbest.net (smhjr@surfbest.net)]

If someone has global aphasia how can you diagnose severe verbal
apraxia? It is impossible. People can have verbal apraxia without
swallowing apraxia so using the swallow apraxia to diagnose verbal
apraxia is also not possible.

The simplest way to diagnose swallowing apraxia is to feed the
patient vs having patient self feed. If they do better self feeding
than you are dealing with swallowing apraxia in addition to whatever
systemic problems you have (ie, vocal fold paralysis, facial droop,
etc.).

Sara Hoffman, MS, CCC-SLP

---- Original Message ----
From: s_langer@juno.com
To: 
Subject: RE: [Dysphagia] swallow apraxia
Date: Wed, 18 May 2005 02:07:36 GMT

>
>Hi all
>
>What are the signs and symptoms of swallow apraxia?  How can it be
>differentially diagnosed from difficulty initiating/triggering
>swallow for some other reason?
>
>Pt. in question is about 80 yo, s/p CVA with global aphasia and
>severe oral/verbal apraxia. Pt. also has significant OM weakness and
>dysphagia.
>
>Upon admission, when taking cup sips thin liquid, pt. triggered
>swallow only ~1/3 of the time; increased to ~50% of the time with
>nectar-thick.  This is gradually improving; at this point, swallow
>generally triggered after every swallow, but often delayed.
>
>MBS performed this AM to R/O silent aspiration.  Pt. p/w lengthy oral
>prep, decreased A-P transport/lengthy OTT, decreased BOT retraction,
>prem. loss of bolus to valleculae with all trials, and spillover to
>pyriforms with thin.  Swallow delay with solids, increased with
>increased cohesion (min for finely ground...to mod-severe for soft
>solid), but not with liquids.
>
>Questions:
>
>1.  Does this sound like swallow apraxia to you? (why/why not?)
>
>2. What are s/s swallow apraxia?  How can it be differentially
>diagnosed?
>
>3.  What are some tx. techniques/strategies appropriate for this dx?
>
>Would appreciate any thoughts/comments ppl could offer.
>
>Thanks
>Sharon Langer MA CCC-SLP
>
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