[Dysphagia] GBS and exercises

[sharon.manders at gmail.com (Sharon Manders)]

Hello,

I have a new pt - 38 yr old female. An oral motor assessment revealed
little/no function CN VII and reduced CN XII (left only). She
basically has no movement of anything above her bottom lip. Her
swallowing is fine, she has naturally some trouble holding a straw
effectively but compensates somewhat with her bottom lip. The
neurologist told me that it might take approx 3 months to regenerate
the nerves, as her GBS was so severe that the axons are likely
damaged, but exercises are not contraindicated. Also, apart from her
initial presentation, she developed the facial/oral motor weakness
after being in hospital for a few days. Original onset was approx 1
month ago. Her trach was removed yesterday and her vocal quality and
strength are very good.

My main question is: are there any exercises that I should be trying?
I gave her some to try to work on her lips and cheeks (puffing out
cheeks, trying to open and close her lips against the pressure of her
fingers, etc.) She still cannot close her eyes completely and is
receiving artificial tears p.r.n. She is highly motivated, English
speaking and cognitively intact. I don't do much treatment at all, but
would like to do something for this lady. I realize that spontaneous
recovery will play a big part, but is there anything I can do to help
it along?

Many thanks in advance,

Sharon