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Previous Volume 346:1174-1175 April 11, 2002 Number 15 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: Dysphagia occurs in more than 50 percent of patients with Parkinson's disease.¹ Although all the phases of swallowing can be involved, dysphagia due to hyperactivity of the upper esophageal sphincter is the prevalent abnormality.¹

Dysphagia does not respond to dopaminergic therapy.¹ Surgical myotomy of the cricopharyngeal muscle is the treatment of choice for hyperactivity of the upper esophageal sphincter due to neurologic disorders,² including Parkinson's disease.³ However, cricopharyngeal myotomy requires general anesthesia and is not always effective.²

Botulinum neurotoxin type A has been used to treat dysphagia.^4,5 We describe its use in four patients (three men and . . . [Full Text of this Article]

References

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• Alfonsi, E., Versino, M., Merlo, I. M., Pacchetti, C., Martignoni, E., Bertino, G., Moglia, A., Tassorelli, C., Nappi, G. (2007). Electrophysiologic patterns of oral-pharyngeal swallowing in parkinsonian syndromes. Neurology 68: 583-589 [Abstract] [Full Text]  
• Restivo, D. A., Marchese-Ragona, R., Lauria, G., Squatrito, S., Gullo, D., Vigneri, R. (2006). Botulinum Toxin Treatment for Oropharyngeal Dysphagia Associated With Diabetic Neuropathy. Diabetes Care 29: 2650-2653 [Abstract] [Full Text]  
• Restivo, D. A., Maimone, D., Patti, F., Marchese-Ragona, R., Marino, G., Pavone, A. (2005). Trismus after stroke/TBI: Botulinum toxin benefit and use pre-PEG placement. Neurology 64: 2152-2153 [Full Text]  
• Jankovic, J (2004). Botulinum toxin in clinical practice. J. Neurol. Neurosurg. Psychiatry 75: 951-957 [Abstract] [Full Text]