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Parkinsonism Relat Disord. 2014 Nov;20(11):1109-18. doi: 10.1016/j.parkreldis.2014.08.013. Epub 2014 Aug 27.

Drooling in Parkinson's disease: a review.

Author information

1
Division of Neurology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 10700, Thailand; Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA.
2
Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA; Govind Ballabh Pant Hospital, New Delhi 110002, India.
3
Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA. Electronic address: hallettm@ninds.nih.gov.

Abstract

Parkinson's disease (PD) is a neurodegenerative disease causing both motor and non-motor symptoms. Drooling, an excessive pooling and spillover of saliva out of the oral cavity, is one of the non-motor symptoms in PD patients that produces various negative physical and psychosocial consequences for patients and their caregivers. At present, the pathophysiology of drooling in PD is not completely certain; however, impaired intra-oral salivary clearance is likely the major contributor. There are neither standard diagnostic criteria nor standard severity assessment tools for evaluating drooling in PD. In accordance with the possible pathophysiology, dopaminergic agents have been used to improve salivary clearance; however, these agents are not completely effective in controlling drooling. Various pharmacological and non-pharmacological treatment options have been studied. Local injection with botulinum toxin serotypes A and B into major salivary glands is most effective to reduce drooling. Future research to explore the exact pathophysiology and develop standard diagnostic criteria and standard severity assessment tools are needed to formulate specific treatment options and improve patient care.

KEYWORDS:

Botulinum toxin; Drooling; Parkinson's disease; Sialorrhea

PMID:
25200111
PMCID:
PMC4252747
DOI:
10.1016/j.parkreldis.2014.08.013
[Indexed for MEDLINE]
Free PMC Article
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