Prepharyngeal dysphagia in Parkinson's disease

Dysphagia in patients with Parkinson's disease (PD) is most often attributed to pharyngeoesophageal motor abnormalities. In our study of patients with idiopathic PD, attention was focused on prepharyngeal symptoms and motor functions. Using the Hoehn and Yahr disease severity scale, patients we...

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Bibliographic Details
Published in:Dysphagia 1996, Vol.11 (1), p.14-22
Main Authors: Leopold, N A, Kagel, M C
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Arm - physiopathology
Cineradiography
Deglutition Disorders - etiology
Deglutition Disorders - physiopathology
Dentistry
Eating
Feeding Behavior
Female
Fluoroscopy
Head
Humans
Male
Mandible - physiopathology
Mastication
Masticatory Muscles - physiopathology
Middle Aged
Mouth - physiopathology
Movement Disorders - etiology
Movement Disorders - physiopathology
Muscle Rigidity - etiology
Muscle Rigidity - physiopathology
Neck
Parkinson Disease - complications
Pharynx - physiopathology
Posture
Tongue Diseases - etiology
Tongue Diseases - physiopathology
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Summary:Dysphagia in patients with Parkinson's disease (PD) is most often attributed to pharyngeoesophageal motor abnormalities. In our study of patients with idiopathic PD, attention was focused on prepharyngeal symptoms and motor functions. Using the Hoehn and Yahr disease severity scale, patients were grouped into those with mild/moderate disease [subgroup I (n = 38)] and those with advanced disease [subgroup II (n = 34)]. Dysphagia symptoms were present in 82% of all patients, but subgroup I patients voiced significantly more complaints. Conversely, many prepharyngeal abnormalities of ingestion, including jaw rigidity, impaired head and neck posture during meals, upper extremity dysmotility, impulsive feeding behavior, impaired amount regulation, and lingual transfer movements were statistically more frequent in subgroup II patients. Impaired mastication and oral preparatory lingual movements were the most common aberrations observed during dynamic videofluoroscopy (48/71), with most patients being concordant for both. The motor disturbances of ingestion reported herein reflect the disintegration of volitional and automatic movements caused by PD-related akinesia, bradykinesia, and rigidity.
ISSN:0179-051X
1432-0460
DOI:10.1007/BF00385794