Treatment of Drooling in Parkinson’s Disease

  • Stephen GrillEmail author
Part of the Current Clinical Neurology book series (CCNEU)


Persons with Parkinson’s disease are frequently not able to control their saliva and then experience drooling. This is irritating and embarrassing to patients but also may lead to significant medical consequences increasing the risk of aspiration pneumonia. Those with minimal drooling do not need specific treatment. For patients with more severe drooling, a stepped approach is taken. This includes the use of anticholinergic agents including sublingual atropine drops and, if that is not sufficient, botulinum toxin injections targeting the parotid and submandibular glands.


Drooling Sialorrhea Atropine drops Botulinum toxin Salivary glands 

Supplementary material

Video 16.1

This demonstrates the technique for injecting botulinum toxin for drooling. The parotid injection is given half-way between the angle of the mandible and the external auditory canal (in this case 2500 units of rimabotulinum b were injected based on the patient’s prior response). The injection into the submandibular gland (1500 units) is given half-way between the front of the jaw and the angle of the jaw, about 1 cm medially. (WMV 85057 kb)

Suggested Reading

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Parkinson’s and Movement Disorders Center of MarylandElkridgeUSA

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