Electrical Stimulation Helps Swallowing Problems, Facial Nerve Damage

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Nerve damage after a 2008 accident while clearing downed trees from a windstorm left Karl Gubert with left-side facial weakness. His eyelid wouldn't close, his speech was slurred and he had difficulty swallowing.

But the 21-year-old Metamora, Mich. man is back to college and his co-op job thanks in part to therapy that uses mild electrical stimulation to "jump start" muscles and nerves to work properly again.

Neuromuscular electrical stimulation, or e-stim, is most commonly used for people with dysphagia - those who have difficulty swallowing or can't swallow at all due to stroke, surgery or other causes. In Gubert's case, e-stim helped with nerve damage affecting his eyelid and cheek in addition to his swallowing muscles.

In people with dysphagia (dis-FAY-juh), the low electrical current is applied to the throat via four electrodes similar to the ones used for an EKG or ECG. It stimulates the type of muscle fibers used for swallowing, causing them to contract, or adds resistance to those muscles during swallowing exercises to help make them stronger.

"So it would be like doing situps with a weight on your chest," says speech pathologist Kathy Rigley-Rowell, who works at the Beaumont Health Center in Royal Oak. Rigley-Rowell underwent special training and obtained certification to provide the therapy.

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Typically the therapy is used for people for whom exercises alone don't help. It can be used for mild to severe dysphagia and is used in tandem with home exercises. Most insurance plans cover it.

The mild electrical stimulation can produce feelings ranging from tingling and warmth to a grabbing sensation.

Candidates for this therapy first undergo a special X-ray during which they swallow a low-dose radioactive liquid (barium). It shows whether food and liquids are going down correctly.

E-stim is not for people who don't have the stamina and strength to do the exercises or the ability to follow directions. People with pacemakers can have the therapy, but Beaumont staff check with the patient's heart doctor first.

The therapy is also offered at all three Beaumont Hospitals - Grosse Pointe, Royal Oak and Troy.

Dysphagia is most common in older adults, premature babies and people with brain or nervous system problems. It happens when the muscles and nerves that help food on its way to the stomach via the throat and esophagus don't work properly or when something blocks the same pathway.

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