Swallowing therapy in neurological diseases

Swallowing disorders are a frequent symptom in many neurological diseases, especially in stroke and Parkinson's disease. Diagnostic tools comprise history taking, bedside examination as well as instrumented methods like fibreoptic endoscopic evaluation of swallowing (FEES) and/or a videofluoroscopic swallowing study (VFSS). Since only a few basic diseases can be treated by medicine or other interventions like surgery and/or radiochemo therapy, swallowing therapy is mainly based on functional methods and strategies for compensation and adaptation. Many of these methods are evaluated by studies and evidence-based. The aim of the interventions is to prevent dehydration, malnutrition, aspiration and aspiration pneumonia, to enable oral or at least semi-oral nutrition and to enhance quality of life. Therefore outcome assessment should focus on clinically relevant parameters, such as nutrition scores or health-related quality of life.