[Dysphagia in Parkinson disease].

Clinical studies were carried out on 97 patients with Parkinson disease. Radiological and manometric studies were performed on 9 patients. The patients histories revealed about 30% had a feeling of dysphagia. Recognition of dysphagia especially in the second phase increases with an increase in duration of the disease and with deterioration of ADL. More than 40% of patients who suffered more than ten years or whose conditions were more severe than third degree of Yahr's scale complained of dysphagia. Some patients felt the disturbance in the first or the third phase of swallowing from the early stage. X-ray studies disclosed abnormal findings in 6 patients including delayed initiation of swallowing (3 patients), vallecular stasis (3 patients), aspiration (2 patients) and slight dilatation of lower esophagus (2 patients). Abnormal findings in oral phase were more severe than those in pharyngeal phase. Manometric study showed high intraluminal resting pressure of the lower esophagus and loss of negative wave in the lower esophageal sphincter after swallowing, suggesting the disturbance of smooth muscle of esophagus. Cricopharygeal dysfunction and disturbance of peristaltic wave of esophagus were not obvious. Pharynx and striated muscle of esophagus were not so severely involved. Dysfunction of tongue and lower esophagus are thought to be probably due to the disturbance of the extrapyramidal system and the autonomic nervous system, respectively.