When most people think of Parkinson’s Disease, they think of the shaking, stiffness, and slowed movement associated with it. Parkinson’s also affects the muscles we use for speech and eating. While these are common issues, they are often neglected in the earlier stages of the disease.

Having a softer voice with slurred speech and having difficulty with eating may seem to be minor obstacles in the early stages of the disease, but they will affect the ability to communicate and eat, as well as affect the quality of life overall. Recognizing these symptoms early on and seeking early treatment may avoid the issues from getting worse and may allow the patient to live a better life overall.

Why Can’t a Person with Parkinson’s Swallow?

Parkinson’s starts with the gradual degeneration of dopamine-producing nerve cells. Dopamine is a key component in the smooth and controlled movement of muscles throughout the body. This includes the muscles we use for speech and eating. Once the muscles used for speech and swallowing become too stiff or too slow, speech and swallowing become difficult. Some people may deal with these symptoms early on, while others may deal with them later on.

What are the Symptoms of an Early Voice Disorder?

When voice changes occur, they present in a very gradual manner. For this reason, these changes are very easy to miss. Often a family member will recognize these symptoms before the person.

Early symptoms of voice change include:

• Becoming a quieter or softer speaker
• Hoarse and/or breathy speech
• Slurred words
• Speech that is too fast or too slow
• Speech that is difficult to understand
• Lack of ability to show emotions in the face while speaking (masked facies)
• Speaking in a monotone manner

Due to these voice changes, the person may become frustrated with having to socialize and may start to avoid social situations.

Signs of Difficulty Swallowing

Dysphagia is a medical term for when one is unable to eat or drink safely. It can come with a variety of symptoms.

Some of the symptoms can be:

• Finding it hard to swallow food or drink
• Coughing or choking while swallowing
• Feeling of food getting stuck in the throat
• Extended meal times
• Poor swallowing can cause drooling
• Frequent clearing of the throat
• Losing weight without trying
• Chest infections from food entering the lungs

Once you notice a few of these symptoms, it is imperative to see a medical professional. These can lead to aspiration pneumonia and malnutrition.

Diagnosing Difficulty Swallowing

The faster the symptoms of dysphagia are diagnosed, the faster treatment can be implemented. A medical professional can evaluate your symptoms and refer you to a speech-language therapist for a more in-depth evaluation.

To receive this evaluation, you may have to undergo:

• An interview of your symptoms and history
• An exam of your nervous system
• An assessment of your speech and/or voice
• An eval of your swallow
• A video fluoroscopic swallowing exam
• A fibre optic swallowing study

These assessments can help identify the cause and prompt treatment.

Treatment of Difficulty Swallowing

Though there is no cure for Parkinson’s disease, there are treatment options for difficulties with swallowing.

These can include:

Medication

With the potential to have more control over your symptoms, some speech and swallowing issues may improve.

Speech Language Therapy

This treatment has the potential to strengthen the muscles necessary for speech and even improve the volume and clarity of your speech.

Through this therapy, you can learn techniques to help control swallowing, thereby decreasing the chances of choking.

Swallowing Management

All of these habits can make swallowing safer: take smaller mouthfuls, chew thoroughly, sit upright, and don’t rush through meals. Sometimes, changes to your diet or the way in which the food is prepared can help.

Healthy Lifestyle

A balanced diet and good oral hygiene and hydration can support your health. Hydrating and keeping active can help keep your muscles strong and your coordination optimal.

When Should You See a Doctor?

While swallowing difficulties, a softer/slurred voice, or repeated coughing with eating can result in unexplained weight loss, seeking help from a neurologist is warranted. These symptoms can worsen with time if you do not seek help.

The sooner you seek help, the sooner the doctors can help with therapies and treatments that can help prevent complications and help you remain confident and independent.

Conclusion

Difficulties with swallowing and your voice can be one of the first symptoms of non-motor Parkinson’s symptoms but tend to be overlooked. A softer voice, unclear speech, and swallowing difficulties can impact communication, nutrition, and overall health. The struggles can be lessened with early diagnosis, therapy, and medication changes.

At Royal Care Neurosciences, our experienced neurologists provide comprehensive care for Parkinson’s disease. With early diagnosis and personalized treatment and expert rehabilitation to move from therapy with our help to voice and swallowing difficulties, we help our patients reach a higher level of functioning.

FAQs

1. Can Parkinson’s affect your voice?

Yes, Parkinson’s can make your voice softer, more hoarse, and more monotone. Slurred speech or speech that is more difficult to understand can also occur.

2. Why do people with Parkinson’s struggle to swallow?

Swallowing uses a large number of muscles. With Parkinson’s, the muscles that control swallowing become rigid, making it difficult to move food and fluids to the stomach. Complications include choking and aspiration pneumonia.

3. Are speech and swallowing issues in Parkinson’s treatable?

Yes, symptoms may not become completely resolved but can be treated with a combination of communicative therapies, swallowing therapies, medications, and a modified diet. The patient can then communicate and swallow with a lower risk to their health.