Therapy-resistant dysphagia successfully treated using pharyngeal electrical stimulation in a patient with the pharyngeal-cervical-brachial variant of the Guillain-Barré syndrome.

Pharyngeal electrical stimulation (PES) is a novel treatment for oropharyngeal dysphagia resulting from neurogenic causes such as stroke, prolonged intubation, tracheostomy, or multiple sclerosis, and may be effective in other medical conditions such as Guillain-Barré syndrome (GBS). A 74-year-old male patient with a pharyngeal-cervical-brachial (PCB) variant of GBS, who had been tracheotomised due to severe and persistent swallowing difficulties (dysphagia) unresponsive to traditional speech and language therapy, received PES therapy as a final treatment option. Swallow performance evaluated before and after PES using fibreoptic endoscopic evaluation of swallowing, videofluoroscopy and clinical bedside assessment, showed significant improvement in swallowing resulting in safe tracheostomy decannulation 18 days after PES.

Multiple-source current steering in subthalamic nucleus deep brain stimulation for Parkinson's disease (the VANTAGE study): a non-randomised, prospective, multicentre, open-label study.

Background: High-frequency deep brain stimulation (DBS) with a single electrical source is effective for motor symptom relief in patients with Parkinson's disease. We postulated that a multiple-source, constant-current device that permits well defined distribution of current would lead to motor improvement in patients with Parkinson's disease.

Methods: We did a prospective, multicentre, non-randomised, open-label intervention study of an implantable DBS device (the VANTAGE study) at six specialist DBS centres at universities in six European countries.