Document Detail

Jaw opening and swallow triggering method for bilateral-brain-damaged patients: K-point stimulation.
MedLine Citation:
PMID:  12355142     Owner:  NLM     Status:  MEDLINE    
The aim of this study was to confirm the response in patients stimulated at the trigger point (K-point). Since we have already clinically encountered patients with hyperactive bite reflexes who were able to open their mouth and swallow after stimulation of the trigger point, we investigated this response in other brain-damaged patients. The trigger point lies on the mucosa lateral to the palatoglossal arch and medial to the pterygomandibular fold at the height of the postretromolar pad. A total of 57 brain-damaged patients, including patients with pseudobulbar palsy due to bilateral upper motor neuron disease and bulbar palsy due to medulla oblongate. Other supratentorial brain-damaged patients and 20 non-brain-damaged subjects were also examined. The subjects were gently stimulated at the trigger point by a finger or a tongue depressor. We found that the pseudobulbar palsy patients with a hyperactive bite reflex responded by mouth opening and swallowing after a jaw movement similar to mastication elicited by the stimulation. The other pseudobulbar palsy patients, who did not have hyperactive bite reflexes and could open their mouth spontaneously, responded by swallowing with jaw movements similar to mastication after the stimulation. The bulbar palsy patients and the supratentorial brain-damaged patients showed no response to the stimulation. The non-brain-damaged subjects also did not respond, but all of the subjects reported a strange sensation after the stimulation. We concluded that stimulating the trigger point was useful for opening the mouth and facilitating swallowing in pseudobulbar palsy patients and that this technique may be of help in these patients in terms of oral health care and feeding.
Chieko Kojima; Ichiro Fujishima; Ruri Ohkuma; Hiroshi Maeda; Isamu Shibamoto; Kyoko Hojo; Motoko Arai
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Dysphagia     Volume:  17     ISSN:  0179-051X     ISO Abbreviation:  Dysphagia     Publication Date:  2002  
Date Detail:
Created Date:  2002-09-30     Completed Date:  2002-10-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8610856     Medline TA:  Dysphagia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  273-7     Citation Subset:  D; IM    
Department of Rehabilitation Medicine, Seirei-Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan.
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MeSH Terms
Aged, 80 and over
Brain Damage, Chronic / physiopathology*
Deglutition / physiology*
Jaw / physiopathology*
Middle Aged
Physical Stimulation

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