Esophageal Motility in Neuromuscular Disorders

Abstract

Using intra-luminal pressure recording techniques investigations of the esophageal sphincter function, resting tone, and wave function were carried out in 38 males and 4 females with various neurological diseases. Decrease in peristaltic waves with or without esophageal spasm could be found in patients with lesions in many locations centrally and peripherally along the neuromuscular pathways. In addition to the peristaltic abnormalities the esophageal motility in patients with amyotrophic lateral sclerosis also exhibited impaired sphincter activity. Patients suffering from cerebral vascular disease with pseudobulbar palsy and with Parkinson''s disease exhibited decreased peristalsis. Evidence was also presented that interference with vagal innervation bilaterally, at a super nuclear, nuclear, or peripheral level seem to be often associated with motility abnormalities. In multiple sclerosis diffuse esophageal spasm was the predominant abnormality. Myasthenia Gravis was the only condition with steadily decreasing wave amplitude and the upper one third to one half of the esophagus with repetitive swallowing was noted. In myotonic dystrophy prolonged relaxation, decreased wave amplitude in the upper esophageal and peristaltic abnormality is predominated.