[Dysphagia] Gag and epiglottis

[eripley at yahoo.com (Irene Campbell-Taylor)]

This gentleman?s problem is clearly esophageal. Epiglottic deflection is of no importance since it is the apposition of the arytenoids against the epiglottic base that is the primary protection of the airway. One can swallow perfectly well without an epiglottis as long as the base is intact and arytenoid function preserved.
   
  Palate Elevation and Gag Reflex (CN IX, X) Does the palate elevate symmetrically when the patient says, "Aah"? Does the patient gag when the posterior pharynx is brushed? 
  What is Being Tested? Palate elevation and the gag reflex are impaired in lesions involving CN IX, CN X, the neuromuscular junction, or the pharyngeal muscles. Many normal individuals have no gag reflex and its presence or absence is not related to the ability to swallow. A very brisk gag reflex, however, MAY indicate UMN lesion as in ALS for example.


Dr I Campbell-Taylor
Clinical Neuroscientist
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