Marianne is a 40-year-old female who went to the emergency ward with acute shortness of breath, following a few days of symptoms consistent with an upper respiratory tract infection. On arrival, she presented with inspiratory stridor, a husky voice, coughing episodes, and haemoptysis (coughing up blood). Her oxygen saturation levels worsened and she was transferred to the intensive care unit (ICU).
Initially, Marianne was treated for supraglottitis. Later, an MRI indicated a left-sided (L) lateral medullary infarct (LMI), which was attributed to a vertebral artery dissection with associated thrombosis. While in the ICU, she required intubation to maintain her airway and then a tracheotomy. Her intensive care admission was complicated by an acute episode of aspiration pneumonia and oesophagitis. In the early days following her stroke, Marianne presented with many classical signs of LMI, also known as Wallenberg syndrome. Wallenberg syndrome is a cluster of symptoms that typically involves vestibulocerebellar signs and symptoms, sensory alterations, and bulbar muscle weakness.
Claire Layfield, BA(HONS), MSLP
Claire Layfield has been practicing as a clinical speech pathologist since 2006 primarily working with adults in both acute and rehabilitation settings with acquired swallowing and communication impairments. She has maintained an interest in medical and health research throughout this time and has presented at state, national and international conferences. She has contributed to the development of the Speech Pathology Australia Position Statement on Neuromuscular Electrical stimulation for dysphagia rehabilitation and contributed to the 2011 revision of the Speech Pathology Australia position paper in general dysphagia management. She has been co-leader of the NSW Evidence Based Practice Network Group for Adult Language since 2010-2012 and Adult Dysphagia Group 2012-2014. As a researcher she hopes to bridge the gap between research and clinical practice and facilitate the use of evidence based practice into everyday clinical settings
Kirrie Ballard, PhD
Kirrie Ballard is Professor and Australian Research Council Future Fellow at the University of Sydney, Australia. Her work focuses on speech motor control and learning; understanding how speech motor control changes across the lifespan, how it is influenced by neurological damage, and factors affecting response to rehabilitation.
Related Courses
1https://www.speechpathology.com/slp-ceus/course/dysphagia-in-neurodegenerative-disease-9732Dysphagia in Neurodegenerative DiseaseDysphagia is common in individuals with amyotrophic lateral sclerosis (ALS) and Parkinson’s disease. This course discusses the underlying pathophysiology and appropriate treatment programs for each disease, as well as use of alternate methods of nutrition/hydration.auditory, textual, visual
Dysphagia is common in individuals with amyotrophic lateral sclerosis (ALS) and Parkinson’s disease. This course discusses the underlying pathophysiology and appropriate treatment programs for each disease, as well as use of alternate methods of nutrition/hydration.
2https://www.speechpathology.com/slp-ceus/course/treating-in-gray-zone-post-10066Treating in the Gray Zone: Post-Acute Care ConsiderationsThis course helps post-acute care clinicians better understand how to approach treatment when things aren’t black and white. It addresses scenarios such as geriatric frailty/weight loss and diet modification, the paradigm shift to a patient-choice model, legal considerations regarding diet waivers, and the care plan process. The SLP's role on the post-acute interdisciplinary team is also discussed.auditory, textual, visual
This course helps post-acute care clinicians better understand how to approach treatment when things aren’t black and white. It addresses scenarios such as geriatric frailty/weight loss and diet modification, the paradigm shift to a patient-choice model, legal considerations regarding diet waivers, and the care plan process. The SLP's role on the post-acute interdisciplinary team is also discussed.
3https://www.speechpathology.com/slp-ceus/course/decision-making-for-alternate-nutrition-9581Decision Making for Alternate Nutrition and Hydration - Part 1This is Part 1 of a two-part series about alternate nutrition and hydration (ANH). This course reviews patient and family concerns that impact the ANH decision-making process, including religious beliefs and culture. Advance directives are discussed and resources for patients/families are provided.auditory, textual, visual
This is Part 1 of a two-part series about alternate nutrition and hydration (ANH). This course reviews patient and family concerns that impact the ANH decision-making process, including religious beliefs and culture. Advance directives are discussed and resources for patients/families are provided.
4https://www.speechpathology.com/slp-ceus/course/dysphagia-after-traumatic-brain-injury-8815Dysphagia after Traumatic Brain Injury: Etiology and EvaluationThis is Part 1 of a two-part series. This course discussed dysphagia following traumatic brain injury (TBI). Specifically, etiology, characteristics, and assessment of dysphagia following TBI are addressed.auditory, textual, visual
This is Part 1 of a two-part series. This course discussed dysphagia following traumatic brain injury (TBI). Specifically, etiology, characteristics, and assessment of dysphagia following TBI are addressed.
5https://www.speechpathology.com/slp-ceus/course/neurogenic-dysphagia-case-studies-across-9185Neurogenic Dysphagia in Older Adults with Motor Disorders: Part 1This is Part 1 of a two-part series demonstrating the evidence related to neurogenic dysphagia resulting from various motor disorders in older adults. The bodily systems involved in dysphagia will be elucidated and advice for applying these concepts to clinical practice will be provided. Case studies of individuals with Huntington's Disease, Parkinson's and Lewy Body Dementia will be presented.auditory, textual, visual
This is Part 1 of a two-part series demonstrating the evidence related to neurogenic dysphagia resulting from various motor disorders in older adults. The bodily systems involved in dysphagia will be elucidated and advice for applying these concepts to clinical practice will be provided. Case studies of individuals with Huntington's Disease, Parkinson's and Lewy Body Dementia will be presented.
