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Dysphagia in progressive supranuclear palsy: radiologic features

N A Leopold1, M C Kagel

  • 1Department of Medicine, Crozer-Chester Medical Center, Upland, PA 19013, USA.

Dysphagia
|July 1, 1997
PubMed
Summary

Progressive supranuclear palsy (PSP) causes swallowing difficulties (dysphagia) similar to Parkinson's disease (PD). This study details swallowing impairments in 10 PSP patients, highlighting common issues across all ingestion stages.

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Area of Science:

  • Neurology
  • Gastroenterology
  • Speech-Language Pathology

Background:

  • Progressive supranuclear palsy (PSP) is a neurodegenerative disease often misdiagnosed as Parkinson's disease (PD).
  • Dysphagia, or difficulty swallowing, is a common and serious complication in PSP, yet poorly characterized.
  • Existing research on PSP dysphagia is limited, necessitating further investigation.

Purpose of the Study:

  • To characterize the neurologic features and swallowing function in patients with progressive supranuclear palsy.
  • To detail the specific abnormalities observed during dynamic videofluoroscopic swallowing studies in dysphagic PSP patients.

Main Methods:

  • Retrospective review of 10 patients diagnosed with progressive supranuclear palsy and dysphagia.
  • Analysis of neurologic examinations and dynamic videofluoroscopic swallowing function (VFSS) studies.

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  • Detailed documentation of abnormalities across all stages of the swallowing process.

    • Main Results:

    • All 10 patients exhibited multiple swallowing stage abnormalities.
    • Common findings included uncoordinated lingual movements, absent velar function, impaired bolus transit, and excessive pharyngeal secretions.
    • Additional observed issues in at least half the cohort were related to mastication, oral bolus control, pharyngeal leakage, vallecular retention, epiglottic dysfunction, and hiatal hernias.

    Conclusions:

    • Swallowing impairments in PSP are complex and affect multiple stages of ingestion.
    • While some dysphagia features overlap with Parkinson's disease, distinct differences require further study with larger cohorts.
    • Comprehensive VFSS is crucial for understanding and managing dysphagia in PSP.