Disordered swallowing due to a syrinx: correction by shunting.

Disturbed deglutition is common in diseases of the brainstem and lower cranial nerves, but little is known about the mechanisms involved. We studied a 49-year-old man with symptoms of syringomyelia and syringobulbia lasting 7 years. Esophageal motility studies showed inability to initiate swallowing, esophageal hypomotility, and absence of the lower esophageal sphincter. After decompression of the syrinx by shunting, these abnormalities were corrected, and the patient could once again eat without aspiration. Medullary dysfunction caused by the syrinx was probably responsible for the swallowing difficulties.