Bradyphagia in patients with Parkinson's disease

Introduction:

Swallowing disorders are a frequent symptom in Parkinson's disease. In literature prevalence is given between 20 and 100 percent. Usually, swallowing disorders occur in the late states of the disease and lead to aspiration and pneumonia. The videoendoscopic pharyngolaryngoscopy provides an efficient method for diagnosing penetration or aspiration of different media (liquid, puree, bread) and for measuring the velocity of the food-transit.

Methods:

Ten Parkinson-patients and ten stroke-patients, in each case with probable swallowing disorders, underwent a videoendoscopic pharyngolaryngoscopy. The duration of the pharyngeal swallowing and of the epiglottic occlusion was quantified.

Results:

In both groups a deglutition reflex, in time or at least delayed, was triggered by the food-inflow into the oropharynx. Only in the Parkinson-group the passage-time was extended.

Conclusion:

Probably, there is a prolonged pharyngeal transit-time of food (bradyphagia) in Parkinson-patients with swallowing disorders compared to stroke-patients. Further investigations should clarify, wether this bradyphagia can be detected already before the occurance of clinically proven swallowing disturbances in order to start an early swallowing therapy.

References:

Alfonsi E et al.: Electrophysiologic patterns of oral-pharyngeal swallowing in parkinsonian syndromes; Neurology 2007; 68: 583–590.