Eddy D. Palmer, MD,1 described dysphagia in patients with parkinsonism as restricted to cricopharyngeal achalasia and attributed all swallowing problems in this patient population to this single motility dysfunction. The number of patients studied and the extent of his examination of their neuromuscular control for deglutition was not mentioned.
In the Department of Neurology, Northwestern University Medical Center, Chicago, we have examined the neuromuscular control of swallowing in more than 100 patients with Parkinson disease as well as in a population of normal age-matched subjects, by means of cinefluoroscopy and videofluoroscopy. Oral, pharyngeal, and esophageal transit times for each patient have been measured to tenths of a second. The motility patterns of lingual, pharyngeal, and esophageal musculature have been examined in detail by means of frame-by-frame analysis of the films and slow-motion analysis of videotapes. Confirming the reports of numerous other researchers,2-4 we have found cinefluorography to be highly