In some neurodegenerative diseases, such as PSP, MSA, and CBD, when symptoms involve swallowing, patients may exhibit nutritional impairment, dehydration, misaspiration, and even recurrent aspiration pneumonia. At this time, PEG treatment needs to be considered, with attention to the following aspects: 1. The patient’s own decisions are crucial and should be given sufficient respect and attention. 2. Discuss treatment options in detail before serious communication difficulties arise, which should include family members, caregivers and therapists. 3. For patients who are willing to make a choice before they “have to,” PEG is undoubtedly the most rewarding. Possible benefits: 1) No more struggle to consume water 2) Reduced risk of aspiration 3) Prevention of further weight loss 4) Possibility of administering medication via PEG 5) Patients can still eat orally, if possible Possible risks: 1) PEG is an invasive procedure 2) The above situation dictates that the patient needs to be observed in the hospital for several days 3) Possibility of intraoperative infections 4) Choking and coughing still exist when swallowing saliva As patients vary, some patients feel that PEG improves quality of life, while others do not find it worthwhile. The final choice still needs to be made by the patient.