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Transient postictal dysphagia in older adults with focal structural epilepsy.

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Title: Transient postictal dysphagia in older adults with focal structural epilepsy.
Authors: Lapa, Sriramya (AUTHOR), Schwingshackl, Anna (AUTHOR), Frank, Ulrike (AUTHOR), Rosenow, Felix (AUTHOR), Mann, Catrin (AUTHOR), Strzelczyk, Adam (AUTHOR)
Source: Epilepsia (Series 4). May2024, Vol. 65 Issue 5, p1374-1382. 9p.
Subjects: Epilepsy, Aspiration pneumonia, Partial epilepsy, Older people, Deglutition disorders, Intensive care patients, Older patients
Abstract: Objective: Seizures can cause transient neurological symptoms, such as hemiparesis and aphasia. However, temporary swallowing changes leading to postictal dysphagia have not been previously described. Therefore, this study evaluated the presence of swallowing disorders following seizure. In addition, dysphagia severity and duration of any recovery from dysphagic symptoms were investigated. Methods: The local clinical database of all fiberoptic endoscopic evaluation of swallowing (FEES) examinations performed from 2008 to 2019 was screened for patients diagnosed with seizures, but excluding patients with intensive care unit admission or intubation >24 h. Patient charts were evaluated to identify preexisting dysphagia or potential concurrent medical causes for dysphagia, including hyponatremia, increased intracranial pressure, sepsis, or other encephalopathies associated with infections, or other possible causes at the time of admission. Patients receiving >.5 defined daily doses of benzodiazepines or neuroleptics were also excluded. Age, sex, seizure semiology and etiology, comorbidities, concurrent pneumonia, and dysphagia course during hospitalization were evaluated as predictors of the occurrence of dysphagia or its potential duration. Results: We identified 41 patients with dysphagia following a seizure, without evidence of any concurrent cause of swallowing dysfunction. These patients all presented with focal structural epilepsy, they had a mean age of 79 ± 11.3 years (range = 44–95 years), and 21 were women. The mean Elixhauser Comorbidity Score was 4.8. Hospital‐acquired pneumonia was detected in 21 patients (51.2%). FEES diagnosed mild and severe dysphagia in 21 (51.2%) and 20 (48.8%) patients, respectively. Dysphagia improved significantly (p =.001) during hospitalization, persisting for an average of 3.9 days (median = 3 days, SD = 2.07 days, range = 1–8 days). Significance: Dysphagia is a potential transient neurological deficit following seizure. Our findings suggest that older patients, with focal structural epilepsy, are at risk for postictal dysphagia. Further studies are needed to ascertain the prevalence, complications, and predictors of postictal dysphagia. Dysphagia screening may improve early detection in patients with relevant risk factors, as well as reduce the occurrence of aspiration pneumonia. [ABSTRACT FROM AUTHOR]
Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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PubTypeId: academicJournal
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  Data: Transient postictal dysphagia in older adults with focal structural epilepsy.
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  Data: <searchLink fieldCode="AR" term="%22Lapa%2C+Sriramya%22">Lapa, Sriramya</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Schwingshackl%2C+Anna%22">Schwingshackl, Anna</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Frank%2C+Ulrike%22">Frank, Ulrike</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rosenow%2C+Felix%22">Rosenow, Felix</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mann%2C+Catrin%22">Mann, Catrin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Strzelczyk%2C+Adam%22">Strzelczyk, Adam</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Epilepsia+%28Series+4%29%22">Epilepsia (Series 4)</searchLink>. May2024, Vol. 65 Issue 5, p1374-1382. 9p.
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  Data: <searchLink fieldCode="DE" term="%22Epilepsy%22">Epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Aspiration+pneumonia%22">Aspiration pneumonia</searchLink><br /><searchLink fieldCode="DE" term="%22Partial+epilepsy%22">Partial epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Older+people%22">Older people</searchLink><br /><searchLink fieldCode="DE" term="%22Deglutition+disorders%22">Deglutition disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Intensive+care+patients%22">Intensive care patients</searchLink><br /><searchLink fieldCode="DE" term="%22Older+patients%22">Older patients</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: Seizures can cause transient neurological symptoms, such as hemiparesis and aphasia. However, temporary swallowing changes leading to postictal dysphagia have not been previously described. Therefore, this study evaluated the presence of swallowing disorders following seizure. In addition, dysphagia severity and duration of any recovery from dysphagic symptoms were investigated. Methods: The local clinical database of all fiberoptic endoscopic evaluation of swallowing (FEES) examinations performed from 2008 to 2019 was screened for patients diagnosed with seizures, but excluding patients with intensive care unit admission or intubation >24 h. Patient charts were evaluated to identify preexisting dysphagia or potential concurrent medical causes for dysphagia, including hyponatremia, increased intracranial pressure, sepsis, or other encephalopathies associated with infections, or other possible causes at the time of admission. Patients receiving >.5 defined daily doses of benzodiazepines or neuroleptics were also excluded. Age, sex, seizure semiology and etiology, comorbidities, concurrent pneumonia, and dysphagia course during hospitalization were evaluated as predictors of the occurrence of dysphagia or its potential duration. Results: We identified 41 patients with dysphagia following a seizure, without evidence of any concurrent cause of swallowing dysfunction. These patients all presented with focal structural epilepsy, they had a mean age of 79 ± 11.3 years (range = 44–95 years), and 21 were women. The mean Elixhauser Comorbidity Score was 4.8. Hospital‐acquired pneumonia was detected in 21 patients (51.2%). FEES diagnosed mild and severe dysphagia in 21 (51.2%) and 20 (48.8%) patients, respectively. Dysphagia improved significantly (p =.001) during hospitalization, persisting for an average of 3.9 days (median = 3 days, SD = 2.07 days, range = 1–8 days). Significance: Dysphagia is a potential transient neurological deficit following seizure. Our findings suggest that older patients, with focal structural epilepsy, are at risk for postictal dysphagia. Further studies are needed to ascertain the prevalence, complications, and predictors of postictal dysphagia. Dysphagia screening may improve early detection in patients with relevant risk factors, as well as reduce the occurrence of aspiration pneumonia. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1111/epi.17914
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      – Code: eng
        Text: English
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      Pagination:
        PageCount: 9
        StartPage: 1374
    Subjects:
      – SubjectFull: Epilepsy
        Type: general
      – SubjectFull: Aspiration pneumonia
        Type: general
      – SubjectFull: Partial epilepsy
        Type: general
      – SubjectFull: Older people
        Type: general
      – SubjectFull: Deglutition disorders
        Type: general
      – SubjectFull: Intensive care patients
        Type: general
      – SubjectFull: Older patients
        Type: general
    Titles:
      – TitleFull: Transient postictal dysphagia in older adults with focal structural epilepsy.
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            NameFull: Lapa, Sriramya
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            NameFull: Schwingshackl, Anna
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            NameFull: Frank, Ulrike
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            NameFull: Rosenow, Felix
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            NameFull: Mann, Catrin
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            – D: 01
              M: 05
              Text: May2024
              Type: published
              Y: 2024
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              Value: 65
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              Value: 5
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            – TitleFull: Epilepsia (Series 4)
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