Swallowing apraxia: A disorder of the praxis system?

The gut-pose of this review is to evaluate the disorder of swallowing aprax ia and determine how it fits into the praxis system. Swallowing apraxia, a proposed disorder of lingual, labial, and mandibular coordination, has been observed before bolus transfer during the oral stage of swallowing. Althou gh frequently discussed anecdotally in dysphagia literature, the possible m echanisms and neural networks of swallowing apraxia have not been elucidate d. Similarities and differences of swallowing apraxia with buccofacial, spe ech, and limb apraxias are evident. Critical review of the literature has i dentified possible similarities as greater occurrence upon command, transit ive nature of the action, and evidence of spatial errors. Conversely, diffe rences such as hemispheric lateralization and multiple gesture assessment m ay exist between swallowing apraxia and more traditional forms of apraxia, Until discrete error patterns of swallowing apraxia are identified and prec isely measured, the nature of this disorder and its relationship with the p raxis system will continue to remain elusive.