Dysphagia in Parkinson’s disease

Dysphagia in Parkinson’s can result in impaired safety, aspiration pneumonia, malnutrition and dehydration and consequently to a well-documented decline of quality of life (QOL) in patients diagnosed with Parkinson’s (PwPD). The underlying neurodegenerative mechanisms in central and peripheral nervous system affect all phases of swallowing in PwPD, while marked heterogeneity has been observed in symptomatology of swallowing impairments within PwPD and atypical parkinsonian symptoms. Further research is needed to understand how early should we screen and assess for swallowing impairments and nutritional status in PwPD, which will in turn have an effect on the optimal therapeutic technique selection and management. This chapter discusses current knowledge on the neurophysiological underpinnings of swallowing impairments in PD, the health outcomes, the relationship of non-motor symptoms with dysphagia and the clinical assessment and management options, among other important issues in PD management.