Esophageal motility disorders in patients with stroke during the acute phase of the disease

Background: Prolonged oropharyngeal dysphagia occurs in up to 45% of patien ts presenting with a unilateral hemiplegic stroke. The aim of this study wa s to investigate esophageal motility in patients with hemiplegic stroke and to evaluate, whether detected motility disorders improve within 10 days af ter the beginning of symptoms. Patients and Methods: Fifteen patients with hemiplegic stroke and dysphagia underwent esophageal manometry within the first 2 days after admission to the hospital and 10 days later. Eighteen healthy volunteers served as contr ols. Results: The following parameters showed no significant differences between the 2 study days (day 2 : day 10 : controls, p-value [comparison with cont rols]): resting pressure of the lower esophageal sphincter: 21 +/- 3 mm Hg : 20 +/- 3 mm Hg: 18 +/- 2 mm Hg, NS, contraction amplitude: 67 +/- 8 mm Hg : 72 +/- 11 mm Hg: 78 +/- 9 mm Hg, NS, duration of contraction: 4.2 +/- 1. 0 s : 4.2 +/- 0.9 s : 2.2 +/- 0.7 s, p < 0.001, and contraction velocity: 6 .3 +/- 1.1 cm/s : 5.2 +/- 0.9 cm/s : 3.2 +/- 0.8 cm/s, p < 0.001. As far as the contraction pattern was concerned,on both study days significant patho logic contraction patterns were seen compared with normal controls. Normal propulsive contractions were seen in 54 +/- 5% : 60 +/- 6% : 96 +/- 5%, p < 0.001. Patients with no dysphagia after 10 days still had demonstrable abn ormal motility patterns. Conclusion: The findings indicate that manometrically demonstrable patholog ic motility patterns of the tubular esophagus in patients without oropharyn geal dysphagia after 10 days do not induce the symptom dysphagia. The funct ion of the esophagus seems not to be impaired by these measurable pathologi c contractions.