Trismus after stroke/TBI: Botulinum toxin benefit and use pre-PEG placement
Citation Manager Formats
Make Comment
See Comments
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Oropharyngeal dysphagia can occur in patients with cerebral damage of different etiologies such as acute stroke and traumatic brain injury (TBI).1,2 The incidence may be as high as 50% in stroke1 and 61% in TBI.2 Dysphagia compromises both nutrition and hydration and can cause severe complications such as aspiration pneumonia and dehydration.
Considering these risks, patients with severe dysphagia are often fed by percutaneous endoscopic gastrostomy (PEG) or nasogastric tubes. PEG is the treatment of choice for persistent dysphagia due to neurologic diseases as it is better tolerated and more acceptable than the nasogastric tube to both patients and caregivers.3 However, PEG placement can be very difficult or even impossible to perform in patients unable to open their mouth owing to spastic closure secondary to neurologic diseases. In these patients, spastic overactivation of masseter muscles can make the manual procedures to passively open the mouth unsuccessful, painful, and dangerous. …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)
Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here
Purchase
Individual access to articles is available through the Add to Cart option on the article page. Access for 1 day (from the computer you are currently using) is US$ 39.00. Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. Distributing copies (electronic or otherwise) of the article is not allowed.
Letters: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Use of Whole-Genome Sequencing for Mitochondrial Disease Diagnosis
Dr. Robert Pitceathly and Dr. William Macken
► Watch
Related Articles
- No related articles found.
Topics Discussed
Alert Me
Recommended articles
-
ARTICLES
Botulinum toxin in severe upper extremity spasticity among patients with traumatic brain injuryAn open-labeled trialStuart A. Yablon, Benjamin T. Agana, Cindy B. Ivanhoe et al.Neurology, October 01, 1996 -
Views & Reviews
Severe tongue protrusion dystoniaClinical syndromes and possible treatmentS. A. Schneider, A. Aggarwal, M. Bhatt et al.Neurology, September 25, 2006 -
Brief Communications
Comparison of efficacy and immunogenicity of original versus current botulinum toxin in cervical dystoniaJ. Jankovic, K.D. Vuong, J. Ahsan et al.Neurology, April 08, 2003 -
Article
ALS dysphagia pathophysiologyDifferential botulinum toxin responseDomenico A. Restivo, Antonino Casabona, Alessia Nicotra et al.Neurology, January 23, 2013