Dysphagia: The Term for Inability to Swallow After Stroke
The medical term for inability to swallow due to cerebrovascular accident (CVA) is "dysphagia," specifically "oropharyngeal dysphagia" or "neurogenic dysphagia" when caused by neurological damage from stroke. 1
Definition and Classification
Dysphagia refers to impairment in swallowing of the upper digestive tract, encompassing both swallowing efficiency and safety problems, with delays in movement timing, reduced range of movements, and potential aspiration. 1 The term specifically describes the swallowing dysfunction that occurs when stroke damages the complex neuromuscular coordination required for safe swallowing. 2
Specific Terminology Used
- Oropharyngeal dysphagia (OD) is the precise term when the impairment affects the oral and pharyngeal phases of swallowing, which is the typical pattern in stroke patients 1
- Neurogenic dysphagia is frequently used to emphasize the neurological origin of the swallowing disorder in conditions like stroke, Parkinson's disease, or dementia 2
- The ICD-10 classification system uses code R13.12 specifically for oropharyngeal dysphagia, while R13.0 denotes complete inability to swallow 1
Clinical Significance in Stroke
Dysphagia occurs in 50% of patients with ischemic or hemorrhagic stroke during the acute phase, making it one of the most frequent and life-threatening symptoms of stroke. 1 These patients face a three-fold increased risk of developing aspiration pneumonia, and their mortality is significantly higher than non-dysphagic stroke patients. 1
Key Clinical Features
- Patients present with difficulties initiating swallowing, often with coughing and choking 2
- Silent aspiration (aspiration without cough reflex) is particularly dangerous and occurs in 71% of patients whose aspiration is detected on videofluoroscopy 3
- Dysphagia increases pneumonia risk 7-fold and serves as an independent predictor of mortality 3
Common Pitfall to Avoid
The absence of coughing during meals does NOT reliably indicate that aspiration is absent. 3, 4 Silent aspiration without obvious clinical signs is extremely common in stroke patients, making instrumental assessment (videofluoroscopy or fiberoptic endoscopic evaluation) essential rather than relying solely on bedside observation. 3, 4