SWALLOWING DISORDER IN PARKINSON'S DISEASE - CHARACTERISTICS, EVALUATION AND TREATMENT

Abstract

Parkinson's disease is a degenerative disease of the basal ganglia in the central nervous system, which is caused by the collapse of dopamine receptors. It represents a neurodegenerative disease characterized by tremors, bradykinesia, numbness and loss of reflexes, but also secondary symptoms of dysarthria and dysphagia. Swallowing disorder is one of the symptoms of Parkinson's disease and in certain situations it can be the first symptom that patients experience without being diagnosed with Parkinsonism. Abnormalities in the form of chin rigidity and difficulty holding the head and neck while eating are observed in patients with severe disease. Dysmolarity, impulsive behavior during food intake and impaired tongue motility are also present. The clinical examination is the beginning of the diagnostic procedure where it is important to determine the degree of difficulty in swallowing, that is, which part of the physiological oropharyngeal process is dominantly affected or the esophagus. Dysphagia therapy is carried out with medication or through speech therapy treatment. Speech therapy treatment includes bolus modification, postural strategies, swallowing maneuvers, thermotactile stimulation (TTS), and neuromuscular electrical stimulation (NMES). Early detection and adequate treatment of swallowing disorders can alleviate or avoid complications such as aspiration, malnutrition and dehydration, which increase the degree of mortality and impair the quality of life of patients with dysphagia. Therefore, the treatment of patients with Parkinson's disease should be approached very seriously and in an interdisciplinary manner in order to provide adequate support and improve the quality of life.