[Dysphagia] conundrum re:estim

[eripley at yahoo.com (Irene Campbell-Taylor)]

Any change in enterally fed patients can only be acounted for by examining the specific patient. Most often, in my experience, it has been simple spontaneous recovery that gets overlooked because no-one follows up and monitors the patient. I have been able to remove scores of patients from G-tubes etc. by simply assessing the swallow and determining that they can. Gradual introduction of food and water has been all that was required. One must be very careful not to assign efficacy to something simply because it is used. Another example is "thermal" stim used in stroke patients who are recoveing anyway - and this is apparently still being employed although it has been shown numerous times to have no effect.

Dr I Campbell-Taylor
Clinical Neuroscientist
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