Neurogenic oropharyngeal dysphagia: concept, pathophysiology, clinic, and therapeutics

the act of swallowing goes beyond a mechanical phenomenon. It is a highly complex process, elaborated and modeled by various levels of the nervous system. Its alteration is a direct consequence or associated complication of several pathologies, where oropharyngeal dysphagia stands out due to functional etiology of neurological and neuromuscular origin. The objective is to update the knowledge about the fundamentals and concept of neurogenic oropharyngeal dysphagia, and to provide clinically useful information on its main causes. Neurological disorders are responsible for 70% to 80% of the etiology of oropharyngeal dysphagia. It is mainly caused by stroke, Parkinson's disease, multiple sclerosis, amyotrophic lateral sclerosis, and head trauma. Conclusions: Neurogenic oropharyngeal dysphagia results from lesions anywhere in the central circuits and structures between the cerebral cortex and the peripheral components of swallowing, and the physiological deficits are varied. The conceptual, pathophysiological, and clinical characteristics understanding of the main causes of neurogenic dysphagia help healthcare teams to carry out timely detection, diagnosis, treatment, and rehabilitation actions.