[Dysphagia] gag reflex

[Paula.Leslie at newcastle.ac.uk (Paula Leslie)]

Absolutely education - if we don't do it no one will.  This is the paper I 
routinely wave at our drs - in The Lancet by one of their own.  It must be 
said that some drs do actually test pharyngeal sensation which is a different 
matter of course.


Paula


Author
Davies, A E; Kidd, D; Stone, S P; MacMahon, J.

Institution
University Department of Geriatric Medicine, Royal Free Hospital School of 
Medicine; University Department of Clinical Neurology, National Hospital for 
Neurology and Neurosurgery, London, UK; Department of Respiratory Medicine, 
Belfast City Hospital.
Correspondence: Dr D Kidd, Neurology Department, St Thomas' Hospital, London 
SE1 7EH, UK.

Title
Pharyngeal sensation and gag reflex in healthy subjects.[Report]

Source
Lancet. 345(8948):487-488, February 25, 1995.

Abstract
The gag reflex is often used in the assessment of swallowing, yet its absence 
does not predict aspiration in acute stroke.Disordered pharyngeal sensation 
has been found to be a sensitive predictor. The occurrence of gag reflex and 
pharyngeal sensation in healthy people is unknown. We studied these tests in 
140 healthy subjects (half elderly and half young). Gag reflex was absent in 
37% of subjects whereas pharyngeal sensation was absent in only 1. The results 
largely explain the low predictive value of gag reflex in the assessment of 
aspiration in acute stroke. Testing pharyngeal sensation would be more likely 
to be useful in these circumstances.




>===== Original Message From "Staci Otto" <otto@email.chop.edu> =====
>I am finding that alot here- but once I share some of the literature (we've 
made lots of copies of a few articles since this keeps coming up) as well as 
my clinical assessment I feel I am making small strides towards education 
about this... at least in my small hole of the world.  suprising that med 
schools are still teaching that when there is research out there... well i 
guess not really that surprising.  :)
>
>Staci Otto MS CCC-SLP
>Children's Hospital of Philadelphia
>215-590-7959
>
>>> "Irene Campbell-Taylor" <eripley@yahoo.com> 01/25/05 9:16 AM >>>
>Medical schools still teach tat gag=swallow. Maybe it's time to do some 
concerted education.
>
>christabel daley <dysphagia@sbcglobal.net> wrote:To revisit an old 
subject........ I am familiar with the literature re the lack of relationship 
between gag & swallowing efficacy. I had a doctor recently comment on a pt who 
presented with functional/unremarkable clinical evaluation, "pt does not have 
a gag, therefore would not cough during clinical evaluation". Am I missing 
something? Pt did consequently go for videoswallow per MD request to find 
results consistent with clinical evaluation.
>Thanks.
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>Dr I Campbell-Taylor
>Clinical Neuroscientist
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Paula Leslie
Degree Programme Director
Surgical and Reproductive Sciences
Faculty of Medical Sciences
University of Newcastle
Newcastle upon Tyne
NE2 4HH
UK
T +44 (0) 191 222 6279
F +44 (0) 191 222 8988
http://www.ncl.ac.uk/sars/postgrad/MSc.htm