BACKGROUND: Prolonged oropharyngeal dysphagia occurs in up to 45% of patients presenting with a unilateral hemiplegic stroke. The aim of this study was to investigate esophageal motility in patients with hemiplegic stroke and to evaluate, whether detected motility disorders improve within 10 days after the beginning of symptoms. PATIENTS AND METHODS: Fifteen patients with hemiplegic stroke and dysphagia underwent esophageal manometry within the first 2 days after admission to the hospital and 10 days later. Eighteen healthy volunteers served as controls. RESULTS: The following parameters showed no significant differences between the 2 study days (day 2: day 10: controls, p-value [comparison with controls]): resting pressure of the lower esophageal sphincter: 21 +/- 3 mm Hg: 20 +/- 3 mm Hg: 18 +/- 2 mm Hg, NS, contraction amplitude: 67 +/- 8 mm Hg: 72 +/- 11 mm Hg: 78 +/- 9 mm Hg, NS, duration of contraction: 4.2 +/- 1.0 s: 4.2 +/- 0.9 s: 2.2 +/- 0.7 s, p < 0.001, and contraction velocity: 6.3 +/- 1.1 cm/s: 5.2 +/- 0.9 cm/s: 3.2 +/- 0.8 cm/s, p < 0.001. As far as the contraction pattern was concerned, on both study days significant pathologic contraction patterns were seen compared with normal controls. Normal propulsive contractions were seen in 54 +/- 5%: 60 +/- 6%: 96 +/- 5%, p < 0.001. Patients with no dysphagia after 10 days still had demonstrable abnormal motility patterns. CONCLUSION: The findings indicate that manometrically demonstrable pathologic motility patterns of the tubular esophagus in patients without oropharyngeal dysphagia after 10 days do not induce the symptom dysphagia. The function of the esophagus seems not to be impaired by these measurable pathologic contractions.
BACKGROUND: Prolonged oropharyngeal dysphagia occurs in up to 45% of patients presenting with a unilateral hemiplegic stroke. The aim of this study was to investigate esophageal motility in patients with hemiplegic stroke and to evaluate, whether detected motility disorders improve within 10 days after the beginning of symptoms. PATIENTS AND METHODS: Fifteen patients with hemiplegic stroke and dysphagia underwent esophageal manometry within the first 2 days after admission to the hospital and 10 days later. Eighteen healthy volunteers served as controls. RESULTS: The following parameters showed no significant differences between the 2 study days (day 2: day 10: controls, p-value [comparison with controls]): resting pressure of the lower esophageal sphincter: 21 +/- 3 mm Hg: 20 +/- 3 mm Hg: 18 +/- 2 mm Hg, NS, contraction amplitude: 67 +/- 8 mm Hg: 72 +/- 11 mm Hg: 78 +/- 9 mm Hg, NS, duration of contraction: 4.2 +/- 1.0 s: 4.2 +/- 0.9 s: 2.2 +/- 0.7 s, p < 0.001, and contraction velocity: 6.3 +/- 1.1 cm/s: 5.2 +/- 0.9 cm/s: 3.2 +/- 0.8 cm/s, p < 0.001. As far as the contraction pattern was concerned, on both study days significant pathologic contraction patterns were seen compared with normal controls. Normal propulsive contractions were seen in 54 +/- 5%: 60 +/- 6%: 96 +/- 5%, p < 0.001. Patients with no dysphagia after 10 days still had demonstrable abnormal motility patterns. CONCLUSION: The findings indicate that manometrically demonstrable pathologic motility patterns of the tubular esophagus in patients without oropharyngeal dysphagia after 10 days do not induce the symptom dysphagia. The function of the esophagus seems not to be impaired by these measurable pathologic contractions.