THE NEUROSCIENTIFIC PRINCIPLES OF SWALLOWING AND DYSPHAGIA.

Abstract

By Arthur J. Miller (Series Editor J. C. Rosenbeck ). 1999. Pp. 284. San Diego and London: Singular Publishing Group Inc. Price £49.50. ISBN 1-56593-859-3. The Singular Publishing Group (http://www.singpub.com) are currently on a roll which celebrates the arrival of dysphagia as a matter of clinical and scientific interest; they have seven books (of which this is one) published in 1998–9 covering dysphagia assessment, treatment, management, cancer, neurogenic dysphagia and the neuroscientific principles to prove it. For a neurologist ten years ago it was difficult to find any mention of the topic in a standard textbook index, so why has this change in interest occurred? It was always appreciated that patients with neurological diseases often died of pneumonia and most clinicians had an intuitive idea of the importance of swallowing and its failure in the genesis of aspiration. In the 1980s, alongside the development of research into stroke and its rehabilitation, a series of papers appeared which emphasized the frequency, but also the brevity, of neurogenic dysphagia in that disorder: in the context of better overall treatments and management, clearly neurogenic dysphagia had to be diagnosed, assessed and managed better. This has led to the application of new and old technologies to analyse swallowing and its disorders, heightened awareness at ward and clinic level of the consequences of neurogenic dysphagia and the development of …