Swallowing difficulty in Parkinson's disease.
Dysphagia is a frequent and potentially serious complication of Parkinson's disease (PD). We examined the oropharyngeal swallowing ability in 19 PD patients (15 men and 4 women, mean age 68.42 years, mean Hoehn and Yahr stage 1.8) using modified barium swallow before and after administering oral levodopa (in combination with benserazide). Twelve (63.2%) patients demonstrated objective evidence of swallowing abnormalities; although only six patients (31.6%) had subjective complaints. Vallecula sinus and pyriform sinus residues were the most frequent abnormalities (47.4% and 42.1%); followed by delayed swallowing reflex (26.3%). Three patients demonstrated silent aspiration. In the 12 patients with abnormal swallowing, six (50%) showed objective improvement after levodopa treatment, while the remaining six showed no change. Of the former group of six, one patient showed improvement in the oral phase, but deterioration in the pharyngeal phase. We concluded that PD patients had a high percentage of objective swallowing abnormalities which could be reduced in half of the patients through the administration of levodopa treatment.
Fuh
J L
JL
Neurological Institute, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
Lee
R C
RC
Wang
S J
SJ
Lin
C H
CH
Wang
P N
PN
Chiang
J H
JH
Liu
H C
HC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000008:administration & dosage; D001466:Barium Sulfate; D001545:Benserazide / Q000008:administration & dosage; D003287:Contrast Media; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009960:Oropharynx / Q000187:drug effects / Q000503:physiopathology; D010300:Parkinson Disease / Q000175:diagnosis* / Q000503:physiopathology; D014743:Videotape Recording
D000978:Antiparkinson Agents; D003287:Contrast Media; D001466:Barium Sulfate; D007980:Levodopa; D001545:Benserazide