Parkinson’s Disease is a disorder of the central nervous system (brain). It is associated with unintended or uncontrollable movements. Patients may have shaking, stiffness and problems with balance and coordination. Although some genetic defects have been detected in some patients causing the disease to rarely be found in families, the most common association according to medical experts is exposure to toxins and environmental agents such as pesticides and herbicides.

Why talk about this neurologic disease in a pulmonary article? Patients with Parkinson’s Disease often have problems with their speech and swallowing. Every year I see several new patients with Parkinson’s Disease who have cough. The cough is usually the result of their neurologic disease and not any lung problem.

The disordered muscle activity these patients experience is not limited to the muscles of the arms and legs but also to the muscles of the chest wall and those muscles in the back of the throat that control swallowing and the voice.

Cough in patients with Parkinson’s Disease is most often related to this impaired function of the back of the throat which leads to discoordinated swallowing and aspiration of saliva and food into the windpipe.

The problem with the swallowing mechanism leaves these patients at risk for frequent pneumonias which can be life threatening. The disordered muscle activity of the chest wall can make it difficult for these patients to cough effectively if they do aspirate. Swallowing studies can help identify the severity of the problem.