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Stroke Doc
Stroke Doc, Board Certified Physician
Category: Neurology
Satisfied Customers: 51
Experience:  I am board-certified in Neurology and the subspecialty Vascular Neurology.
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how long for nerves to be restored to throat so swallowing

Resolved Question:

how long for nerves to be restored to throat so swallowing can resume after brainstem/cerebellum stroke
Submitted: 4 years ago.
Category: Neurology
Expert:  Stroke Doc replied 4 years ago.

It varies from patient to patient; but the data from several studies shows that 80-88% of stroke patients will have near-full or full recovery of swallowing within 4 months. That leaves 10-12% who may take longer or who may never recover enough to be able to swallow on their own. In my personal experience observing thousands of stroke patients, most will have a significant improvement within the first 4 to 6 weeks. But depending upon where in the brainstem the stroke occurred, there may not be significant recovery. The nerve cells that were affected by the stroke will never be "restored." They die during the stroke. Recovery after a stroke comes as nearby cells that can do the same function start to take over that function. For example, if 10,000 cells are involved in swallowing (the actual number is XXXXX greater, but this is just an example) and a stroke takes out 9000 of them, significant difficulty swallowing would be expected. However, if the 1000 remaining cells can sprout appendages (i.e. "axons") that can grow out to the throat muscles, some recovery may be expected. It really depends on how many cells involved in swallowing function were damaged and how many were spared. Nerve axons themselves grow at a rate of 1 to 2 mm a day. So if newly sprouted axons will reach throat muscles, it could take 80 to 100 days for them to do so. It's unfortunately a lengthy process (I've had patients with a separate disease called "axonal-variant Guillain-Barre syndrome" who took nearly 3 years to get full restoration of the nerves to their legs so they could walk normally because nerves grow so slowly).

 

I see that your stroke occurred nearly 5 months ago, and you're still having problems swallowing. I hope it's not the case, but I do want you to understand that not all patients do recover. That said, it was long believed that motor recovery (arm/leg function, for example) cannot occurr with any significance beyond a year out from stroke; but I personally know of a patient who didn't even start trying to recover for 12 years after his stroke and had significant improvement. Don't give up hope; and keep working as hard as you can. You're still within a time period where recovery can occur.

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