Dysphagia and Sialorrhea:

Abstract

-Context -Dysphagia and sialorrhea in patients with Parkinson's disease are both automatically accepted as dependent on this neurological disease. Objective -The aim were to establish if these two complaints are a consequence or associated manifestations of Parkinson's disease. Method -Two Parkinson's diseases groups from the same outpatients' population were studied. Patients in the first group, with dysphagia, were studied by videofluoroscopy. The second, with sialorrhea, were studied by the scintigraphic method, Results -Videofluoroscopic examination of the oral, pharyngeal and esophageal phases of swallowing showed that 94% of Parkinson's diseases patients present, structural causes, not related to Parkinson's diseases, able to produce or intensify the observed disphagia. The scintigraphic examination of Parkinson's diseases patients with sialorrhea showed that there is no increase of serous saliva production. Nevertheless, showed a significantly higher velocity of saliva excretion in the Parkinson's diseases patients.Conclusions -Dysphagia can be due to the muscular rigidity often present in the Parkinson's diseases patient, or more usually by non Parkinson's disease associated causes. In Parkinson's diseases patients, sialorrhea is produced by saliva retention. Nevertheless, sialorrhea can produce discomfort in swallowing, although without a formal complaint of dysphagia. In this case, subclinical dysphagia must be considered. Sialorrhea is indicative of dysphagia or at least of subclinical dysphagia. As final conclusion, Parkinson's diseases can be an isolated cause of dysphagia and/or sialorrhea, but frequently, a factor unrelated to Parkinson's diseases is the main cause of or at least aggravates the dysphagia.

Gastrointestinal dysfunction in idiopathic Parkinsonism: A narrative review

“…Nevertheless, sialorrhea can produce discomfort in swallowing although without a formal complaint of dysphagia. [22] For treating mild symptoms, some experts revealed using chewing gum or hard candy to encourage swallowing and reduce drooling in social situations. [23] When more aggressive intervention is warranted, pharmacologic therapy to reduce saliva production is another option.…”

Assessment of Oropharyngeal Dysphagia in Patients With Parkinson Disease: Use of Ultrasonography

“…Dysphagia is an important problem in PD because it can cause aspiration pneumonia and thereby increase the mortality rate [ 3 ]. There have been many attempts to evaluate dysphagia in PD using VFSS, and they have revealed impairment in the oral and pharyngeal phases.…”

“…There have been many attempts to evaluate dysphagia in PD using VFSS, and they have revealed impairment in the oral and pharyngeal phases. Such impairment includes inappropriate tongue movement, piecemeal deglutition, a delayed swallowing reflex and oropharyngeal transit time, residues in the vallecular space and pyriform fossa, and penetration or aspiration [ 3 6 7 19 ]. Dysphagia assessment using US is a new technique that has been proposed to have many advantages, including lack of radiation, noninvasiveness, and the possibility for use with bedridden patients.…”

“…A patient with PD may first experience movement-related symptoms, including tremor at rest, rigidity, akinesia (or bradykinesia), and postural instability [ 1 ], as well as bulbar dysfunction in the form of dysphagia, dysarthria, hypophonia, and sialorrhea. Non-motor symptoms, autonomic dysfunction, sleep disturbance and behavioral, cognitive and psychiatric problems may also arise as the disease progresses [ 1 2 3 ].…”

Parkinson's Disease: Reflection, Evolution and Understanding of the Disease

“…In Parkinson's disease, the prevalence of dysphagia is estimated to be from 32% to 70%. Nevertheless, the risk posed by dysphagia is neglected or underestimated until the patient suffers the first episode of pneumonia, despite the known high risk of aspiration and pneumonia associated with oropharyngeal dysphagia in PD patients [11].…”