Authors: Reinaldo Teixeira Ribeiro and Orlando Graziani Póvoas Barsottini
Abstract: Neurological diseases can affect the pharynx in many different ways, including its motility and somatic sensation. Therefore, these diseases can impair the main pharyngeal functions, causing disorders of swallowing, speech and breathing. The premise of this chapter is to provide dependable and meaningful knowledge as the foundation for clinical work. This chapter is divided into five subsections based on the cardinal manifestation of the neurological diseases. Each subsection contains disciplined presentation of scientific data and lucid description of etiology, pathophysiology, diagnosis and treatment. The first subsection includes disorders of motility, such as motor paralysis and movement disorders. The second subsection comprises disorders of somatic sensation: for instance, pharyngeal anesthesia and neuropathic pain. The third subsection consists of disorders of swallowing, describing the underlying neural mechanisms of dysphagia and aspiration, and their management. The fourth subsection is focused on the disorders of the articulation of speech: dysarthria and anarthria. The fifth subsection emphasizes breathing disorders, such as obstructive sleep apnea of neurological origin. It is important to consider that patients with neurological diseases and pharyngeal dysfunction consult many physicians from different specialties and other professional caregivers because of a multitude of problematic symptoms. In the quest to offer the best assistance, the reader is encouraged to invade those obscure and difficult territories in the domain of neurologists and expand his notion of a disease by knowledge of its current scientific foundations. The comprehensive involvement of two neurologists in writing this chapter has promoted a uniform approach across subject matter that should be pleasing to the reader.