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Rehabilitation Practice and Science

Translated Title

巴金森氏病患之吞嚥障礙及電視螢光錄影檢查

Abstract

Parkinson's disease (PD) is a degenerative disorder of the nigrostriatal system, and frequently complicated with swallowing difficulties. This paper reviewed the current studies on the scope of the incidence, the clinical symptoms, the use of videofluoroscopic swallowing study (VFSS), and the management of dysphagia in PD. The awareness of dysphagia in PD patients in previous studies was around 31 to 72 %, however, this figure does not reflect the actual severity of swallowing disorders in this group patients. We found a great variability in the incidence of swallowing disorder on VFSS, depending on the patients selected. Around 31 to 92% of patients with PD had abnormal swallowing function in the oral phase and 15 to 97 % in the pharyngeal phase. Aspirations were detected on 16 to 46 % patients by VFSS and most of them were silent. The swallowing abnormalities in VFSS were generalized and worse in the liquid barium. The motor function of PD patients was a poor predictor for the severity of swallowing disorder. The swallowing function improved after treatment with anti-parkinsonism medication, such as levodopa, in half of the PD patients with dysphagia, especially in the patients with oral phase disorders. For patients with dysphagia related to cricopharyngeal muscle dysfunction, myotomy was found to relieve this problem in several reports. The role of rehabilitation is still being debated because of the lack of scientific training programs and related research. The use of VFSS for early detection of aspiration and other swallowing disorders is mandatory to prevent the complications of dysphagia in PD patients.

Language

Traditional Chinese

First Page

151

Last Page

160

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