Research progress in dysphagia associated with autoimmune diseases of nervous system

doi:10.3877/cma.j.issn.2095-123X.2026.02.007

Abstract

Abstract:

In recent years, the epidemiology, clinical manifestations, diagnosis and treatment of autoimmune diseases of the nervous system have gradually attracted clinical attention. Dysphagia is the main or sole clinical manifestation of some autoimmune diseases of the nervous system. The etiology of dysphagia is complex. The common causes are cerebrovascular diseases, oral cavity, esophagus and other space occupying lesions. When autoimmune diseases of the nervous system cause damage to the structural and functional components related to swallowing, the clinical manifestation of dysphagia will occur. This article reviews the research progress of autoimmune diseases of nervous system that may cause dysphagia, aiming to provide references for early diagnosis, clinical assessment, auxiliary examinations and treatment strategies, and to provide a basis for expanding the etiological understanding and diagnostic analysis approaches of dysphagia.

Key words: Nervous system, Autoimmune disease, Dysphagia, Cranial neuropathy

Guanghui Yang, Xiaoguang Cao, Kang Zhou, Ting Wang, Kai Chen, Xiumin Wang. Research progress in dysphagia associated with autoimmune diseases of nervous system[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2026, 16(02): 110-115.

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References 57

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疾病种类	病理机制	受累分期	吞咽障碍表现	评估量表	检查方法	治疗		发病率
疾病种类	病理机制	受累分期	吞咽障碍表现	评估量表	检查方法	药物	非药物	发病率
DM	血管及肌肉周围炎性细胞浸润	口腔期、咽期、食管期	口咽部收缩力受损、环咽功能障碍、喉部抬高减弱和食管运动减弱	常规筛查	VFSS、FEES	糖皮质激素联合免疫抑制剂	康复治疗如球囊扩张训练等,肉毒毒素注射、环咽肌切开术等	18%~58%
IBM	肌质或肌核内有管状细丝包涵体	口腔期、咽期、食管期	口咽期吞咽肌群力量下降、环咽肌功能障碍、喉上抬减少和食管运动异常	常规筛查	VFSS、FEES	药物治疗效果差	调整食物形状、改变进食姿势,肠内营养途径如鼻饲管、胃造瘘、空肠造口管等,肉毒毒素注射、环咽肌切开术等	40%~80%
MG	神经肌肉接头乙酰胆碱被消耗	口腔期、咽期、食管期	口腔、咽喉部肌肉无力及疲劳、食团推进力减弱	无	HRM、FTT、sEMG	溴吡斯的明、类固醇、免疫抑制剂	不推荐	60%
GBS	球麻痹	口腔期、咽期	口腔运送延缓、咽部感觉减退、咽部分泌物残留	常规筛查	VFSS、FEES	激素、IVIG、血浆置换、手术治疗	康复训练如PES、球囊扩张等	41.0%~53.5%
MS	皮质延髓束、小脑及脑干等多部位受累	口腔期、咽期、食管期	食团形成困难、咽部吞咽启动延迟、咽部收缩减弱、环咽肌功能障碍	TWST、DYMUS、SDQ	VFSS、FEES、sEMG等	无	康复训练如PES、rTMS、tDCS等	21%~56%
NMOSD	延髓部疑核、孤束核、迷走神经背核和其间的神经纤维联络受损	咽期、食管期为主	渗漏、误吸、食团过早溢入梨状窝、咽部残留	常规筛查	VFSS、FEES	激素、血浆置换、IVIG、利妥昔单抗等生物制剂	传统康复训练、环咽肌肉毒毒素注射、球囊扩张等	29.50%~61.54%

疾病种类	病理机制	受累分期	吞咽障碍表现	评估量表	检查方法	治疗		发病率
疾病种类	病理机制	受累分期	吞咽障碍表现	评估量表	检查方法	药物	非药物	发病率
DM	血管及肌肉周围炎性细胞浸润	口腔期、咽期、食管期	口咽部收缩力受损、环咽功能障碍、喉部抬高减弱和食管运动减弱	常规筛查	VFSS、FEES	糖皮质激素联合免疫抑制剂	康复治疗如球囊扩张训练等,肉毒毒素注射、环咽肌切开术等	18%~58%
IBM	肌质或肌核内有管状细丝包涵体	口腔期、咽期、食管期	口咽期吞咽肌群力量下降、环咽肌功能障碍、喉上抬减少和食管运动异常	常规筛查	VFSS、FEES	药物治疗效果差	调整食物形状、改变进食姿势,肠内营养途径如鼻饲管、胃造瘘、空肠造口管等,肉毒毒素注射、环咽肌切开术等	40%~80%
MG	神经肌肉接头乙酰胆碱被消耗	口腔期、咽期、食管期	口腔、咽喉部肌肉无力及疲劳、食团推进力减弱	无	HRM、FTT、sEMG	溴吡斯的明、类固醇、免疫抑制剂	不推荐	60%
GBS	球麻痹	口腔期、咽期	口腔运送延缓、咽部感觉减退、咽部分泌物残留	常规筛查	VFSS、FEES	激素、IVIG、血浆置换、手术治疗	康复训练如PES、球囊扩张等	41.0%~53.5%
MS	皮质延髓束、小脑及脑干等多部位受累	口腔期、咽期、食管期	食团形成困难、咽部吞咽启动延迟、咽部收缩减弱、环咽肌功能障碍	TWST、DYMUS、SDQ	VFSS、FEES、sEMG等	无	康复训练如PES、rTMS、tDCS等	21%~56%
NMOSD	延髓部疑核、孤束核、迷走神经背核和其间的神经纤维联络受损	咽期、食管期为主	渗漏、误吸、食团过早溢入梨状窝、咽部残留	常规筛查	VFSS、FEES	激素、血浆置换、IVIG、利妥昔单抗等生物制剂	传统康复训练、环咽肌肉毒毒素注射、球囊扩张等	29.50%~61.54%

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