Sequential water swallowing in normal adults and patients with neurogenic dysphagia

Sequential water swallowing (SWS) is usual ingestive behavior. SWS was used previously on the criteria just in the clinical bases of laryngeal penetration or incomplete drinking of the amount of 90-150 mL water. They did not use any kind of physiological monitoring. Invasive methods such as Videoflouroskopy could not be suitable for continuous deglutition in that time and the amount of fluids because of possible hazardous side effects. Last methods is a kind of discrete swallowing (5-15 mL). Thus we need SWS from a cup or straw. SWS is favorable method for longutidinal studies. SWS investigations from our and other laboratories are not commonly published compared to the other kind of tremendeous swallowing studies. There is a need for a comprehensive review about SWS with the physiological and the clinical results. Four chan-nel electromyography is necessary for submental muscle complex, nasal sensor for respiration, electrocardiogram and the electrodermal activity. A coordination in between swallowing and respiration was found significantly pathologic even in asymptomatic dysphagia in the chronic neurological disorders such as multiple sclerosis, Parkinson’s disease, Parkinson plus syndromes and brainstem infarctions. in amyotrophic lateral sclerosis there was an irregularity in swallowing behavior in almost half of the patients. Guillain Barre syndrome with cranial nerve involvement showed silent dysphagia. Alzheimer disease had a risk of dysphagia in early period and dysphagia was increased, progressively, until the late stage of disease. Therefore the SWS is easy to use, repeatable, safe and a cheap method and this field is especially important and suitable use of neurologist and electromyographer