Table 1

Factors influencing swallowing capacity in neurological patients

 1 Conscious level
 2  Cognition and behaviour (eg, inappropriate “stuffing”, talking while eating)
 3  Head/neck posture and mobility (eg, tracheostomy, neck lines, neck surgery)
 4  Local oropharyngeal and laryngeal factors (eg, poor oral hygiene, dry mouth, secretions, drooling, dentition, dentures, mouth ulcers, sore throat, intubation)
 5  Neurological factors (eg, spasticity, rigidity, weakness (central or peripheral), sensory loss, movement disorder, coordination, loss of voluntary control, exaggeration of oropharyngeal and laryngeal reflexes)
 6  Accompanying symptoms (vertigo, nausea, neuralgic pain (V, IX), syncope (IX))
 7  Gastro-oesophageal function (eg, acid reflux disease)
 8  Breathing and effectiveness of cough (eg, control of respiratory cycle, inspiratory and expiratory capacity, pulmonary function, laryngeal function)
 9  Appetite (affected by illness and medication)
10  Ability to self feed (eg, arm and hand function)
11  Medication (eg, anticholinergic drugs, neuroleptic medication, benzodiazepines)
12  Psychological factors and social factors (eg, confidence, embarrassment, fear)