• Bendix Labeit, Emilia Michou, Shaheen Hamdy, Michaela Trapl-Grundschober, Sonja Suntrup-Krueger, Paul Muhle, Philip M Bath, and Rainer Dziewas.
• Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Muenster, Germany; Institute for Biomagnetism and Biosignal Analysis, University Hospital Muenster, Muenster, Germany. Electronic address: benlabeit@wwu.de.
• Lancet Neurol. 2023 Sep 1; 22 (9): 858870858-870.

AbstractDysphagia is a major complication following an acute stroke that affects the majority of patients. Clinically, dysphagia after stroke is associated with increased risk of aspiration pneumonia, malnutrition, mortality, and other adverse functional outcomes. Pathophysiologically, dysphagia after stroke is caused by disruption of an extensive cortical and subcortical swallowing network. The screening of patients for dysphagia after stroke should be provided as soon as possible, starting with simple water-swallowing tests at the bedside or more elaborate multi-consistency protocols. Subsequently, a more detailed examination, ideally with instrumental diagnostics such as flexible endoscopic evaluation of swallowing or video fluoroscopy is indicated in some patients. Emerging diagnostic procedures, technical innovations in assessment tools, and digitalisation will improve diagnostic accuracy in the future. Advances in the diagnosis of dysphagia after stroke will enable management based on individual patterns of dysfunction and predisposing risk factors for complications. Progess in dysphagia rehabilitation are essential to reduce mortality and improve patients' quality of life after a stroke.Copyright © 2023 Elsevier Ltd. All rights reserved.

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