Treatment of Drooling in Parkinson’s Disease
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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.
KeywordsDrooling Sialorrhea Atropine drops Botulinum toxin Salivary glands
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)
- Barbe AG, Bock N, Derman SHM, Relsch M, Timmermann L, Noack MJ. Self-assessment of oral health, dental health care and oral health-related quality of life among Parkinson’s disease patients. Gerodontology. 2016. (Note: this is still listed as “ahead of print” on-line and I cannot find the full reference as of now).Google Scholar
- Guidubaldi A, Fasano A, Ialongo T, Piano C, Pompilli M, Masciana R, Sicilliani L, Sabatelli M, Bentivoglop AR. Botulinum toxin a versus B in sialorrhea: a prospective, randomized, double-blind, crossover pilot study in patients with amyotrophic lateral sclerosis or Parkinson’s disease. Mov Disord. 2011;26(2):313–9.CrossRefGoogle Scholar