Treatment of dysphagia in Parkinson’s disease

Abstract

Dysphagia is frequently present in individuals with Parkinson’s disease (PD). Abnormalities may be localized to the oral, pharyngeal, or esophageal level and may be evident even in the early stages of the disease. Individuals with dysphagia have an increased risk for aspiration, and silent aspiration may be present in up to one-third of patients with PD. The modified barium swallow (MBS) study is the standard screening test for dysphagia in PD, but it is important to remember that esophageal abnormalities may not be visualized on the MBS and a barium esophagram should be considered if the MBS is negative. Surgical treatment may be curative for structural abnormalities such as a Zenker’s diverticulum, but when the problem is due to oropharyngeal or esophageal dysmotility, speech/swallowing therapy is the most effective treatment.