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May 1977

Dysphagia in Parkinsonism

Arch Neurol. 1977;34(5):320. doi:10.1001/archneur.1977.00500170074019

To the Editor.—  As many as 95% of patients with Parkinson disease have some difficulty with swallowing, but few actually complain of that disability.1.2 Palmer3 believes that dysphagia in parkinsonism is almost always caused by "classical cricopharyngeal achalasia" and recommends posterior cricopharyngeal sphincterotomy; he reports never having seen pulmonary regurgitative problems following this procedure. However, no single cause of dysphagia in Parkinson disease is generally accepted.

Report of a Case.—  A 73-year-old man came to Barnes Hospital with a complaint of several months of dysphagia and severe weight loss. Cine-esophagoscopy revealed aspiration of about one half of the barium swallowed, minimal glottal movement, retention of barium in the hypopharynx, and diminished peristalsis in the lower third of the esophagus. The stigmata of Parkinson disease were noted; the patient was given levodopa plus carbidopa (Sincemet). Subjective improvement in swallowing and increase in intake were quickly noted along with amelioration

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