Skip to main content

Advertisement

Log in

Lewy body dysphagia

  • Case Report
  • Published:
Acta Neuropathologica Aims and scope Submit manuscript

Abstract

The presence of Lewy bodies (LB) in autonomic structures of the central and peripheral nervous system in Parkinson’s disease (PD) is well known and could explain clinical signs of pure autonomic failure (PAF) or dysphagia, frequently associated with the disorder. There are many neuropathological reports in the literature with detailed descriptions of PAF, however, LB dysphagia has thus far only been reported once. In the present study, we describe two cases of isolated dysphagia without extrapyramidal syndrome, diagnosed clinically as progressive supranuclear palsy and amyotrophic lateral sclerosis, where detailed neuropathological examination identified LBs in the dorsal vagal motor nuclei in the medulla. These findings confirm the existence of isolated LB dysphagia and emphasize the importance of detailed neuropathological and immunohistochemical examination in cases of dysphagia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

References

  1. Albers MW, Tabert MH, Devanand DP (2006) Olfactory dysfunction as a predictor of neurodegenerative disease. Curr Neurol Neurosci Rep 6:379–386

    Article  PubMed  Google Scholar 

  2. Braak H, Del Tredici K, Rüb U, de Vos RA, Jansen Steur EN, Braak E (2003) Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging 24:197–211

    Article  PubMed  Google Scholar 

  3. Braak H, Sastre M, Bohl JR, de Vos RA, Del Tredici K (2007) Parkinson’s disease: lesions in dorsal horn layer I, involvement of parasympathetic and sympathetic pre- and postganglionic neurons. Acta Neuropathol (Berl) 113:421–429

    Article  Google Scholar 

  4. Edwards LL, Quigley EM, Pfeiffer RF (1992) Gastrointestinal dysfunction in Parkinson’s disease: frequency and pathophysiology. Neurology 42:726–732

    PubMed  CAS  Google Scholar 

  5. Horimoto Y, Matsumoto M, Akatsu H, Ikari H, Kojima K, Yamamoto T, Otsuka Y, Ojika K, Ueda R, Kosaka K (2003) Autonomic dysfunctions in dementia with Lewy bodies. J Neurol 250:530–533

    Article  PubMed  Google Scholar 

  6. Ince PG, Perry EK, Morris CM (1998) Dementia with Lewy bodies. A distinct non-Alzheimer dementia syndrome? Brain Pathol 8:299–324

    Article  PubMed  CAS  Google Scholar 

  7. Jackson M, Lennox G, Balsitis M, Lowe J (1995) Lewy body dysphagia. J Neurol Neurosurg Psychiatry 58:756–758

    Article  PubMed  CAS  Google Scholar 

  8. Kosaka K, Iseki E (1996) Diffuse Lewy body disease within the spectrum of Lewy body disease. In: Perry RH, McKeith IG, Perry EK (eds) Demetia with Lewy Bodies. Cambridge University Press, Cambridge, pp 238–247

    Google Scholar 

  9. Kosaka K, Matsushita M, Oyanagi S, Mehraein P (1980) [A cliniconeurophathological study of the “Lewy body disease”]. Seishin Shinkeigaku Zasshi 82:292–311

    PubMed  CAS  Google Scholar 

  10. Lang IM, Dean C, Medda BK, Aslam M, Shaker R (2004) Differential activation of medullary vagal nuclei during different phases of swallowing in the cat. Brain Res 1014:145–163

    Article  PubMed  CAS  Google Scholar 

  11. Martino R, Terrault N, Ezerzer F, Mikulis D, Diamant NE (2001) Dysphagia in a patient with lateral medullary syndrome: insight into the central control of swallowing. Gastroenterology 121:420–426

    Article  PubMed  CAS  Google Scholar 

  12. Miller N, Noble E, Jones D, Burn D (2006) Hard to swallow: dysphagia in Parkinson’s disease. Age Ageing 35:614–618

    Article  PubMed  Google Scholar 

  13. Muller J, Wenning GK, Verny M, McKee A, Chaudhuri KR, Jellinger K, Poewe W, Litvan I (2001) Progression of dysarthria and dysphagia in postmortem-confirmed parkinsonian disorders. Arch Neurol 58:259–264

    Article  PubMed  CAS  Google Scholar 

  14. Nilsson H, Ekberg O, Olsson R, Hindfelt B (1996) Quantitative assessment of oral and pharyngeal function in Parkinson’s disease. Dysphagia 11:144–150

    Article  PubMed  CAS  Google Scholar 

  15. Potulska A, Friedman A, Krolicki L, Spychala A (2003) Swallowing disorders in Parkinson’s disease. Parkinsonism Relat Disord 9:349–353

    Article  PubMed  Google Scholar 

  16. Ross GW, Abbott RD, Petrovitch H, Tanner CM, Davis DG, Nelson J, Markesbery WR, Hardman J, Masaki K, Launer L, White LR (2006) Association of olfactory dysfunction with incidental Lewy bodies. Mov Disord 21:2062–2067

    Article  PubMed  Google Scholar 

  17. Rüb U, Brunt ER, Del Turco D, de Vos RA, Gierga K, Paulson H, Braak H (2003) Guidelines for the pathoanatomical examination of the lower brain stem in ingestive and swallowing disorders and its application to a dysphagic spinocerebellar ataxia type 3 patient. Neuropathol Appl Neurobiol 29:1–13

    Article  PubMed  Google Scholar 

  18. Tretiakoff C (1919) Contribution à l’étude de l’anatomie pathologique du locus niger de Soemmering. In, Paris, p 293

  19. Wakabayashi K, Takahashi H (1997) Neuropathology of autonomic nervous system in Parkinson’s disease. Eur Neurol 38(Suppl 2):2–7

    PubMed  Google Scholar 

  20. Wuttge-Hannig A, Hannig C (2007) [Neurologic and neuromuscular functional disorders of the pharynx and esophagus.]. Radiologe 47:137–153

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

We thank P. Lovero for excellent technical assistance.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Enikö Kövari.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kövari, E., Burkhardt, K., Lobrinus, J.A. et al. Lewy body dysphagia. Acta Neuropathol 114, 295–298 (2007). https://doi.org/10.1007/s00401-007-0233-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00401-007-0233-6

Keywords

Navigation