ASYMPTOMATIC SWALLOWING DISORDERS IN ELDERLY PATIENTS WITH PARKINSONS-DISEASE - A DESCRIPTION OF FINDINGS ON CLINICAL EXAMINATION AND VIDEOFLUOROSCOPY IN 16 PATIENTS

We sought to ascertain whether patients with Parkinson's disease witho ut symptoms of dysphagia have abnormalities of swallowing, and to desc ribe the characteristics as seen on clinical examination and videofluo roscopy. Patients with stable Parkinson's disease were interviewed for symptoms of dysphagia and 16 asymptomatic patients were enrolled. Whi lst on their usual medication, an examination of facial, tongue and pa latopharyngeal musculature was made, and a modified barium swallow per formed. All patients had at least one abnormality on videofluoroscopic examination of their swallowing. Three patients showed aspiration and 14 had evidence of vallecular residue considered a risk for aspiratio n. Oropharyngeal transit time was invariably prolonged as was delay in the initiation of swallow. The majority of patients also demonstrated an increased number of tongue elevations and number of swallows to cl ear their pharynx of the bolus. Despite having no symptoms of dysphagi a, the patients demonstrated widespread abnormalities of swallowing.