SWALLOWING DIFFICULTY IN PARKINSONS-DISEASE

Dysphagia is a frequent and potentially serious complication of Parkin son's disease (PD). We examined the oropharyngeal swallowing ability i n 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 ad ministering oral levodopa (in combination with benserazide). Twelve (6 3.2%) patients demonstrated objective evidence of swallowing abnormali ties; although only six patients (31.6%) had subjective complaints. Va llecula sinus and pyriform sinus residues were the most frequent abnor malities (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 afte r 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 pati ents had a high percentage of objective swallowing abnormalities which could be reduced in half of the patients through the administration o f levodopa treatment. (C) 1997 Elsevier Science B.V.