Cheung, RTF

Chiu, K

Fong, YM

Ho, SL

Leung, KP

Li, LSW

HKU Scholars Hub

Title Prediction of persistence of neurogenic dysphagia in strokepatientsAuthor(s) Li, LSW; Leung, KP; Chiu, K; Fong, YM; Cheung, RTF; Ho, SLCitationThe 5th Medical Research Conference (MRC 2000), Hong Kong,China, January 2000. In The Hong Kong Practitioner, 2000, v. 22suppl. 2, p. 14Issued Date 2000URL http://hdl.handle.net/10722/46821Rights Creative Commons: Attribution 3.0 Hong Kong LicenseG-N-1PREDICTION OF PERSISTENCE OF NEUROGENIC DYSPHAGIA IN STROKE PATIENTSLSW Li. KP Leung, K Chiu*, YM Fong, RTF Cheung, SL Ho. Department of Medicine, University of HongKong and *Department of Speech Therapy, Tung Wah Hospital, Hong Kong.Background and Objective: Neurogenic dysphagia is a common complication after acute stroke. About 75%of the initially dysphagic patients will have a full recovery when they are discharged from the rehabilitationunit. No outcome prediction on any clinical assessment has been reported in literature This study was toevaluate the predictability of functional recovery by using an outcome measure for swallowing (OMRS) whichhas been validated.Method: Stroke patients with dysphagia were assessed by swallowing videofluoroscopy and the OMRS onadmission to the rehabilitation unit and 3 to 4 months later. Statistical analysis: Spearman correlation is usedto assess the significance of the initial OMRS in predicting the outcome.Results: 27 stroke patients were recruited into the study. The initial OMRS score ranged from 2 to 8 with amean score of 5.2. The follow-up OMRS score ranged from 3 to 9 with a mean score of 7.7. This group ofpatients demonstrated a significant gain of OMRS score of 2.33 points (p<0.00) after swallowing therapy.The initial OMRS score did predict the final OMRS score with a positive correlation coefficient of 0.428(p=0.026). Subgroup analysis showed that a cut off score of 4 or below uniformly predicted a poor prognosis(p<0.007 Fisher's exact test).Conclusion: The results showed that the admission or initial OMRS score is a good predictor of the follow-upOMRS scores at 3-4 months post-stroke. An initial cut-off score of 4 is useful to distinguish between poor andgood recovery of swallowing function.G-N-2OUTCOME ANALYSIS OF EPILEPSY SURGERY IN QUEEN MARY HOSPITALGCY Fong. YW Fan*, KY Fong, RTF Cheung, SL Ho.Division of Neurology, University Department of Medicine, Queen Mary Hospital, Hong Kong.* Department of Neurosurgery, Queen Mary Hospital, Hong Kong.Epilepsy surgery is a functional neurosurgery; it improves seizure control by removal of epileptogenic areaand/or prevention of propagation of epileptic discharges. The surgery is, in general, more effective insymptomatic partial epilepsy syndromes. A meticulous pre-operative workup is needed to identify theepileptogenic focus and a safe resection margin. We have performed 20 operations for 18 patients. Thesurgical outcomes of temporal lobe cases were examined according to University of California, Los Angeles(UCLA) classification. Sixteen patients with temporal lobe epilepsy (TLE) underwent resective surgery withor without language mapping. We followed up these patients prospectively after the operation at the Sai YingPoon Joint Epilepsy Clinic for a period of 24 months. Ninety-three percents (13/14) of them had a favorablesurgical outcome (UCLA class 1 or 2), one patient (7%) remained in class 3 (worthwhile seizure reduction butnot free from disabling seizure) despite vigorous modification of anticonvulsant after surgery. To date, twopatients had not reached the 24 months follow up period. Both had a favorable outcome at the last follow up.One patient reported problems in memory registration and one patient developed non-epileptic seizure aftersurgery. Otherwise, no major complication was observed. We concluded that epilepsy surgery in Queen MaryHospital is an effective and safe alternative for patients with intractable TLE.- 14 -

Prediction of persistence of neurogenic dysphagia in stroke patients

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Prediction of persistence of neurogenic dysphagia in stroke patients

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