Stroke signs tongue
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Stroke Signs: The Role of the Tongue
Introduction to Tongue Diagnosis in Stroke
Tongue diagnosis is a significant method in traditional medicine, particularly in Traditional Korean Medicine (TKM) and Chinese Medicine, for assessing various health conditions, including stroke. This diagnostic technique involves observing the tongue's appearance, color, and movement to infer underlying health issues .
Tongue Deviation as a Stroke Indicator
Frequency and Clinical Characteristics
Tongue deviation is a notable sign in stroke patients, often indicating supranuclear twelfth cranial nerve palsy. Studies have shown that 29% of stroke patients exhibit tongue deviation, compared to only 5% of healthy controls. This deviation typically aligns with the side of limb weakness and is more prevalent in patients with non-lacunar strokes or large cortical and subcortical infarctions. Additionally, tongue deviation is frequently associated with dysphagia and dysarthria, making it a critical clinical sign for stroke diagnosis and management.
Quantification of Tongue Deviation
Recent advancements have introduced methods to quantify tongue deviation angles, enhancing the diagnostic accuracy for stroke. Research indicates that a tongue deviation angle greater than 3.2 degrees can effectively differentiate between stroke patients and healthy individuals, providing a reliable early warning sign for stroke. This quantification method has shown significant differences in tongue deviation angles between stroke, transient ischemic attack (TIA), and normal groups, underscoring its diagnostic value.
Tongue Pressure and Swallowing Dysfunction
Predicting Pneumonia
Swallowing dysfunction, a common complication in stroke patients, can lead to aspiration pneumonia. Tongue pressure measurement is a non-invasive method to evaluate swallowing ability. Studies have demonstrated that low tongue pressure is a strong predictor of pneumonia in acute stroke patients. A tongue pressure below 21.6 kPa significantly increases the risk of pneumonia, highlighting the importance of regular tongue pressure assessments in stroke management.
Improving Swallowing Function
Tongue-to-palate resistance training (TPRT) has been shown to improve tongue strength and oropharyngeal swallowing function in stroke patients with dysphagia. This training involves exercises that enhance tongue muscle strength, leading to better swallowing outcomes. Patients undergoing TPRT have shown significant improvements in both anterior and posterior tongue strength, as well as in swallowing function, compared to those receiving traditional dysphagia therapy alone.
Tongue Exercises for Dysphagia
Tongue Stretching Exercises
Tongue stretching exercises (TSE) are another effective intervention for improving tongue motility and oromotor function in stroke patients with dysphagia. These exercises involve dynamic and static passive stretching, which significantly enhance tongue movement and swallowing efficiency. Patients performing TSE have shown marked improvements in tongue motility, bolus formation, and oral transit time, making TSE a recommended treatment for post-stroke dysphagia.
Assessing Tongue Strength
Assessing tongue strength can also help predict the risk of penetration and aspiration in stroke patients. Instrumental assessments like the videofluoroscopic swallowing study (VFSS) combined with tongue strength measurements provide a comprehensive evaluation of swallowing disorders. Cut-off values for tongue strength during the swallowing of different food consistencies can guide clinical decision-making and reduce the risk of pneumonia.
Conclusion
Tongue diagnosis, including the observation of tongue deviation and measurement of tongue pressure, plays a crucial role in the early detection and management of stroke. Quantifying tongue deviation angles and implementing tongue strength training exercises can significantly improve diagnostic accuracy and patient outcomes. These methods not only aid in identifying stroke but also in preventing complications such as aspiration pneumonia, thereby enhancing the overall quality of care for stroke patients.
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