Language and swallowing disorders in acute stroke patients: Tools and early management

Introduction. - The contribution of stroke units to improve morbidity, mortality and recovery in stroke victims is clearly demonstrated. However, acute management of language disorders in these specialized units is controversial and little standardization is seen for the management of swallowing disorders. State of the art. - The recently validated French scale for rapid screening for language disorders (LAST) in acute stroke patients should enable optimal detection and early management. A standardized protocol should be used to screen for and manage swallowing disorders. This protocol should include daily evaluations, individually tailored rehabilitation sessions, adaptation of food textures, patient education for adequate eating position, team training, and information for families. Perspectives and conclusions. - These protocols imply co-operation and coordination between the medical and allied profession teams and the daily presence of a speech and language therapist. This presence is crucial for patients in stroke units to achieve the full benefits of the management scheme proposed in this paper. (C) 2012 Elsevier Masson SAS. All rights reserved.