Patients with recurrent strokes can result in bilateral upper motor neuron lesions (mainly in the motor cortex and its emanating cortical brainstem tracts) with central paralysis of the motor cranial nuclei of the medulla oblongata (nucleus suspensus as well as the trigeminal motor nucleus of the pons) that they innervate. Clinically, this can manifest as central paralysis of the tongue, soft palate, pharynx, face and masticatory muscles (medically named pseudobulbar palsy), resulting in swallowing dysfunction. Swallowing is one of the complex behaviors governed by the brain and is a continuous action that ends in a few seconds. “Phase 3: the food passes through the esophagus and is pushed into the stomach by peristalsis, called the “peristaltic phase”. Food aspiration often occurs in phase 2, when respiration stops and the soft palate and epiglottis are atretic, which increases the pressure in the mouth and causes the gag reflex, so that food does not enter the trachea; in some stroke patients, due to dysfunction of the tongue, soft palate, and pharyngeal muscles caused by lesions of the innervated motor neurons, during phase 2 of swallowing, if respiration does not stop and epiglottis atresia is incomplete, the pressure in the mouth cannot be increased, and the tongue’s ability to control food weight is reduced. The ability of the tongue to control the weight of the food is weakened, and it cannot cause the gag reflex, so the food can easily enter the trachea by mistake. Therefore, when the patient eats or drinks, if the speed is too fast and the volume is too large, it will cause frequent coughing and even aspiration pneumonia, which will further aggravate the cough.