Oesophageal manometry in patients after stroke with or without oropharyngeal dysphagia

Background and objective: As many as 45% of all strokes can lead to permanent dysphagia, usually considered to be due to abnormal oropharyngeal coordination of contraction. It was the aim of the study to compare oesophageal motility in stroke patients with and without dysphagia. Patients and methods: The study group consisted of 36 patients (13 men, 23 women, mean age 74,1 +/- 11.3 years) who had sustained a stroke (19 [mean age 70,6 +/- 10,5 years] with and 17 [mean age 77,6 +/- 10,5 years] without dysphagia). All these patients underwent oesophageal manometry within 2 days after hospital admission. Results: There were significant differences in the mean proportion of regular peristaltic waves in the distal oesophagus, 93,5 +/- 1,1 % in patients without but in only 53,5 +/- 4.4% of those with dysphagia (P<0.0001). Measurement of the proximal oesophagus showed 93,2 +/- 3,4% and 62,1 +/- 7,3% respectively. There was no significant difference between these two patient cohorts with regard to the resting pressure in the upper and lower oesophageal sphincters as well as in the amplitude and duration or speed of contraction in the region of the smooth and striated oesophageal muscles. Conclusions: In patients after a stroke who have dysphagia abnormalities of oesophageal motility are also of importance for their symptoms, being due less to pressure relations than to abnormal contraction patterns.