Voluntary aspects of feeding (mastication and swallow initiation) are controlled by centers in the cerebral cortex. Corticobulbar tracts descend bilaterally to the pons and medulla with bilateral centers that control the muscles of swallowing. These centers consist of well-known cranial nerve nuclei (e.g., the nucleus ambiguus) as well as ill-defined groups of neurons nearby that are essential for the regulation of swallowing. The input from each cerebral hemisphere to the brain-stem nuclei is distributed bilaterally so that the brain-stem centers continue to work after unilateral cortex or corticobulbar tract destruction.
KeywordsNucleus Ambiguus Diffuse Esophageal Spasm Pseudo Bulbar Palsy Spinocerebellar Degeneration Esophageal Dysphagia
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