CLINICAL INDEX OF DYSPHAGIA LIMIT IN PARKINSONS PATIENTS

Parkinsons disease is a progressive neurodegenerative disorder characterized by motor and non motor symptoms. The oropharyngeal dysfunction is common in parkinsons disease. Pharyngeal dysmotility ,prolongation of the duration of pharyngeal reflexes due to slowness of sequential muscle movements constitute abnormalities of pharyngeal phase. AIM : To evaluate the oropharyngeal phase of swallowing in parkinsons patients using a simple bed side clinical test DYSPHAGIA LIMIT.METHODS 30 Subjects attending neurologymovement disorder OPD at RGGGH, Chennai were included in the study, of which 15 were patients diagnosed to have Parkinsons disease and 15 were normal age matched controls .The individuals were instructed to swallow stepwise increase in the bolus volume of water as 5ml,10ml respectively .The volume of fluid at which the division of bolus occurs is labeled the dysphagia limit.RESULTS15 patients and 15 age sex matched normal control groups were included , of which 18 were males and 12 were females with a mean age group of 63.9.The mean UPDRS scoring was 24.6 and the disability scoring by HoehnYahr staging was 1.6.The mean volume of fluid swallowed in a single bolus by Parkinsons patients was 16.6ml and in the control group was 26.6ml and was found to be statistically significant (p0.001).The normal people have a higher volume of fluid consumed in single bolus than parkinsons patients. CONCLUSION: DYSPHAGIA LIMIT is a useful bed side clinical test to assess the oropharyngeal phase of swallowing .