What is the role of swallowing electromyography in the workup of dysphagia?

Updated: Mar 20, 2020
  • Author: Nam-Jong Paik, MD, PhD; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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Mechanical upward-downward movement of the larynx is detected by using a piezoelectric sensor while submental integrated EMG activity is recorded during dry and wet swallowing. EMG activity of the cricopharyngeal muscle of the upper esophageal sphincter also can be recorded. [47]

In patients with muscular disorders, laryngeal elevators are involved, whereas the cricopharyngeal sphincter is intact. In patients with clinical signs of involvement of the corticobulbar fiber (eg, patients with ALS and pseudobulbar palsy), discoordination between paretic laryngeal elevators and the hyperreflexic cricopharyngeal sphincter is present.

EMG can be used for muscle selection and for performing injections of botulinum toxin in patients with dysphagia caused by cricopharyngeal muscle spasm or hypertonicity.

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