Unable to Swallow Evaluation
Evaluation of difficulty swallowing starts with a medical history and physical examination.
Physical findings in someone with difficulty swallowing due to stroke may include:
- Sudden numbness in one arm or leg:
- Sudden weakness in one arm or leg:
- Facial weakness (unilateral):
- Difficulty walking
- Difficulty with balance
- Loss of coordination
- Memory loss
In most cases, testing is necessary to evaluate difficulty swallowing.
Tests that may be used to evaluate difficulty swallowing include:
- Serum amylase
- Serum lipase
- Complete blood count
- Barium swallow
- Chest x-ray
- Esophageal manometry:
- Measuring the pressure inside the esophagus
- Upper GI endoscopy
Because strokes and TIAs can cause difficulty swallowing, tests may be required to evaluate stroke as a cause of difficulty swallowing.
Tests that may be used to evaluate stroke or TIA include:
- CT scanning of the brain
- MRI scan of the brain
- SPECT scanning of the brain:
- A newer method that may provide earlier detection of stroke in some cases
- PET scanning of the brain:
- Detects levels of brain activity
- Blood clotting studies
- Serum electrolytes
- Serum glucose
- Pulse oximetry
A stroke or TIA may be caused by narrowing of the blood vessels in the neck, called the carotid arteries.
Tests that may be used to evaluate the carotid arteries include:
- Carotid angiogram:
- A special x-ray procedure that can detect blood vessel narrowing in the carotid arteries, which often cause strokes.
- Carotid duplex ultrasound:
Tests that may be used to screen for conditions that increase the risk of a stroke include:
Continue to Unable to Swallow Treatment
- Achem SR, Devault KR. Dysphagia in aging. J Clin Gastroenterol. 2005 May-Jun;39(5):357-71. 
- Cook IJ, Kahrilas PJ. AGA technical review on management of oropharyngeal dysphagia. Gastroenterology. 1999 Feb;116(2):455-78. 
- Leslie P, Drinnan MJ, Ford GA, Wilson JA. Swallow respiratory patterns and aging: presbyphagia or dysphagia? J Gerontol A Biol Sci Med Sci. 2005 Mar;60(3):391-5. 
- Rubenstein JH, Inadomi JM. Dysphagia drives doctors to diagnose a disease: pitfalls in interpreting observational studies. Gastrointest Endosc. 2005 Jun;61(7):809-11.