Those in the early stages of Parkinson’s disease might be unaware of oral movement changes and oral phase dysphagia. In fact, these changes of the oral swallow can occur early enough in the disease that they can be the first sign of Parkinson’s. Oral residue, piecemeal swallow, poor bolus formation, premature spillage, repetitive pumping movements of the tongue, and rocking-rolling festination movement of the tongue are frequent findings of this population.
In today’s Modified Monday, you will see tongue rolling that is present in a patient that was diagnosed with Parkinson’s Disease. It is a serpentine, repetitive movement that can prolong AP transit. When seeing a movement like this, if there is not a neurological etiology already identified, a neurological consult should be strongly considered. A speech language pathologist’s ability to identify this could be the first step in early diagnosis of the disease.
Kwon M., Lee J.H. Oral Pharyngeal Dysphagia in Parkinson’s Disease and Related Movement Disorders. Journal of Movement Disorders. 2019; 12(3):152-160.