Dysphagia-Onset Parkinsonism in an Older Patient: Serial Videofluoroscopic Observations

Dysphagia-onset parkinsonismDysphagia in older adults predisposes to aspiration pneumonia and has many causes, and a neurodegenerative origin may be overlooked when it is the only complaint.In degenerative parkinsonian disorders, dysphagia usually follows the motor signs; it appears early in multiple system atrophy and progressive supranuclear palsy, 1 and the Movement Disorder Society (MDS) criteria list severe dysphagia within the first five years as a red flag against Parkinson's disease (PD). 2 Even in PD, objective abnormalities appear earlier than expected, and aspiration has been reported in 20% of patients within two years of onset.3 Severe