PHARYNGOESOPHAGEAL DYSPHAGIA IN PARKINSONS-DISEASE

The radiologic characteristics of pharyngoesophageal (PE) dysfunction in Parkinson's disease (PD) are not well established, partly because m ost 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 sever ity scale, patients were subdivided into those with mild/moderate dise ase, subgroup I(n = 38), and advanced PD disease, subgroup II (n = 33) . From pharyngeal ingestion to gastric emptying, bolus transport was n ormal in only 2 patients. The most common abnormalities occurring duri ng pharyngeal ingestion included impaired motility, vallecular and pyr iform 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, bo lus redirection, and tertiary contractions. Typical aberrations of low er esophageal sphincter (LES) function included an open or delayed ope ning of the LES and gastroesophageal reflux. A pathogenesis linking PE with the pathology of PD is proposed.