DYSPHAGIA  [ back to Glossary Index ]
Dysphagia is a disorder of swallowing which can be caused by traumatic brain damage to the inferior pre-central gyrus (a portion of the motor cortex), the insula, the hypothalamus, the cerebellum, the brain stem or cranial nerves V, VII, IX, X or XI. Dysphagia is fairly common following a severe TBI.  I have not yet seen or heard of a case of dysphagia associated with a mild TBI, although I must assume it is possible. Dysphagia is a highly serious disorder since we cannot eat, drink or survive without swallowing unless someone is feeding us with liquid nutrition through an IV tube. Dysphagia can be, and very frequently is, cured or substantially improved through intensive, bed-side therapy in the hospital once the severe TBI patient wakes from coma. Normal swallowing involves 4 phases. The first two of them (the oral preparatory and oral stage) involve voluntary muscle contraction. The latter two (the pharyngeal and the esophageal stages) are involuntary or automatic. Occupational therapy is designed to restore swallowing skills during the first two stages, which are potentially under voluntary control.