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Diagnostik und Therapie der Dysphagie nach einem Schlaganfall

Diagnostics and treatment of post-stroke dysphagia

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An Erratum to this article was published on 15 June 2023

This article has been updated

Zusammenfassung

Hintergrund

Dysphagie nach einem Schlaganfall ist hochprävalent und führt zu schwerwiegenden Komplikationen wie Aspirationspneumonie und Mangelernährung. Trotz der hohen klinischen Relevanz ist das Dysphagiemanagement heterogen und oft unzureichend.

Fragestellung

Ziel dieses Reviewartikels ist es, einen Überblick über die diagnostischen und therapeutischen Strategien der schlaganfallbedingten Dysphagie auf der Grundlage aktueller Studien zu geben.

Material und Methode

Narratives Literaturreview.

Ergebnisse

Ein Dysphagiescreening sollte bei jedem Schlaganfallpatienten so früh wie möglich durchgeführt werden, z. B. mit einem Wasserschlucktest oder einem Multikonsistenzprotokoll. Anschließend ist bei Patienten mit auffälligem Screening oder bestehenden Risikofaktoren für Dysphagie eine flexible endoskopische Evaluation des Schluckens (FEES) indiziert. Therapeutisch können diätetische Modifikationen, Maßnahmen der Mundhygiene und eine Ernährungstherapie dazu beitragen, Komplikationen zu verringern. Logopädische Beübung oder experimentelle Therapien wie Neurostimulationsverfahren und pharmakologische Therapien zielen auf eine Verbesserung der Schluckfunktion ab und haben in Studien vielversprechende Ergebnisse gezeigt.

Schlussfolgerung

Ein frühzeitiges Dysphagiemanagement ist notwendig, um Komplikationen zu reduzieren.

Abstract

Background

Post-stroke dysphagia is highly prevalent and leads to severe complications, such as aspiration pneumonia and malnutrition. Despite the high clinical relevance dysphagia management is heterogeneous and often inadequate.

Objective

The aim of this review article is to provide an overview of the diagnostic and treatment strategies for post-stroke dysphagia based on recent studies.

Material and methods

Narrative literature review.

Results

Dysphagia screening should be performed as early as possible in every stroke patient, e.g., with a simple water swallowing test or a multiconsistency protocol. Subsequently, flexible endoscopic evaluation of swallowing (FEES) is indicated in patients with abnormal screening results or existing risk factors for dysphagia. Dietary modifications, oral hygiene measures, and nutritional therapy can help reduce complications. Behavioral swallowing therapy or experimental therapies, such as neurostimulation procedures and pharmacological approaches aim to improve swallowing function and have shown promising results in studies.

Conclusion

Timely management of dysphagia is necessary to reduce complications.

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Author information

Authors and Affiliations

  1. Klinik für Neurologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland

    Bendix Labeit

  2. Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Münster, Deutschland

    Paul Muhle &  Sonja Suntrup-Krueger

  3. Klinik für Neurologie und Neurologische Frührehabilitation, Klinikum Osnabrück, Osnabrück, Deutschland

    Rainer Dziewas

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  1. Bendix Labeit
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  2. Paul Muhle
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  3. Rainer Dziewas
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  4. Sonja Suntrup-Krueger
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Corresponding author

Correspondence to Bendix Labeit.

Ethics declarations

Interessenkonflikt

R. Dziewas hat Honorare von Phagenesis erhalten. B. Labeit, P. Muhle, S. Suntrup-Krueger geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Labeit, B., Muhle, P., Dziewas, R. et al. Diagnostik und Therapie der Dysphagie nach einem Schlaganfall. Nervenarzt 94, 676–683 (2023). https://doi.org/10.1007/s00115-023-01483-7

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  • DOI: https://doi.org/10.1007/s00115-023-01483-7

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