Videofluoroscopic
swallowing study (VFSS) used for the
diagnosis of
dysphagia has limitations in objectively assessing the contractility of the
pharyngeal muscle or the degree of the
upper esophageal sphincter relaxation. With a manometer, however, it is possible to objectively assess the
pressure changes in the
pharynx caused by
pharyngeal muscle contraction during
swallowing or
upper esophageal sphincter relaxation, hence remedying the limitations of VFSS. The following case
report describes a
patient diagnosed with lateral medullar
infarction presenting a 52-year-old
male who had
dysphagia. We suggested that the manometer could be used to assess the specific site of dysfunction in
patients with
dysphagia complementing the limitations of VFSS. We also found that repetitive
transcranial magnetic stimulation was effective in treating
patients refractory to traditional
dysphagia rehabilitation.