Pharyngo-esophageal dysphagia in Parkinson's disease

Dysphagia. 1997 Winter;12(1):11-8; discussion 19-20. doi: 10.1007/pl00009512.

Abstract

The radiologic characteristics of pharyngoesophageal (PE) dysfunction in Parkinson's disease (PD) are not well established, partly because most previous studies have examined only small numbers of patients. We administered a dynamic videofluoroscopic swallowing function study to 71 patients with idiopathic PD. Using the Hoehn and Yahr disease severity scale, patients were subdivided into those with mild/moderate disease, subgroup I (n = 38), and advanced PD disease, subgroup II (n = 33). From pharyngeal ingestion to gastric emptying, bolus transport was normal in only 2 patients. The most common abnormalities occurring during pharyngeal ingestion included impaired motility, vallecular and pyriform sinus stasis, supraglottic and glottic aspiration, and deficient epiglottic positioning and range of motion. Esophageal abnormalities were multiple but most commonly included delayed transport, stasis, bolus redirection, and tertiary contractions. Typical aberrations of lower esophageal sphincter (LES) function included an open or delayed opening of the LES and gastro-esophageal reflux. A pathogenesis linking PE with the pathology of PD is proposed.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cineradiography
  • Deglutition
  • Deglutition Disorders / diagnostic imaging
  • Deglutition Disorders / etiology*
  • Deglutition Disorders / physiopathology
  • Esophageal Diseases / diagnostic imaging
  • Esophageal Diseases / etiology*
  • Esophageal Diseases / physiopathology
  • Esophagus / physiopathology
  • Female
  • Fluoroscopy
  • Foreign Bodies
  • Gastric Emptying
  • Gastroesophageal Reflux / etiology
  • Gastroesophageal Reflux / physiopathology
  • Glottis / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Muscle Contraction
  • Parkinson Disease / complications*
  • Parkinson Disease / physiopathology
  • Peristalsis
  • Pharyngeal Diseases / diagnostic imaging
  • Pharyngeal Diseases / etiology*
  • Pharyngeal Diseases / physiopathology
  • Pharynx / physiopathology
  • Video Recording