PDF(Pubmed)
Abstract：
A 90-year-old man with stroke was weaned from tube feeding 4 months after stroke onset. However, he had a coronavirus disease 2019 (COVID-19) infection after 2 months and suffered from drastically worsened oropharyngeal dysphagia that required a reinsertion of the nasogastric tube. A videofluoroscopic swallowing study revealed poor bolus oral transit, significantly delayed swallowing reflex, reduced pharyngeal movements, and insufficient cough response. Repetitive transcranial magnetic stimulation and neuromuscular electrical stimulation were applied, in addition to conventional swallowing training. The feeding tube was removed after 20 treatment sessions. Clinicians should be aware of the risk of dysphagia after COVID-19 infection in patients with underlying neurological diseases. The management of post-COVID-19 dysphagia has not yet been fully established. Repetitive transcranial electrical stimulation combined with neuromuscular electrical stimulation may be used as an auxiliary intervention in specific cases.
摘要：
一名90岁的中风患者在中风发作4个月后断奶。然而,患者在2个月后感染2019年冠状病毒病(COVID-19),口咽吞咽困难严重加重,需要重新插入鼻胃管.视频透视吞咽研究显示，食团口腔转运不良，显著延迟吞咽反射，减少咽部运动，咳嗽反应不足。应用重复经颅磁刺激和神经肌肉电刺激，除了常规的吞咽训练。20次治疗后取出饲管。临床医生应注意神经系统基础疾病患者感染COVID-19后发生吞咽困难的风险。COVID-19后吞咽困难的管理尚未完全建立。在特定情况下，重复经颅电刺激与神经肌肉电刺激相结合可用作辅助干预。
