Drooling In Parkinsons Disease: Difference between revisions
No edit summary |
No edit summary |
||
| Line 10: | Line 10: | ||
Drooling in patients may: cause saliva to spill from their oral cavity: may be aspirated causing aspiration pneumonia; may cause poor oral hygiene and, significantly, social embarrassment.<ref name=":1" /> | Drooling in patients may: cause saliva to spill from their oral cavity: may be aspirated causing aspiration pneumonia; may cause poor oral hygiene and, significantly, social embarrassment.<ref name=":1" /> | ||
== | == Objective Measures == | ||
Drooling screen eg Radboud Oral Motor Inventory for Parkinson’s disease (ROMP)-saliva Assessment | |||
== Non-Pharmacological Treatment == | |||
Include: | |||
* Cues To Swallow, cue them to remember every eg 3 minutes to, such as commands like "gather your saliva in your mouth, tightly close your lips, then swallow". | |||
* Positioning. Posture is important in good swallowing. Work on preventing eg forward head posture which can increase drooling. Teach appropriate seating ergonomics and postural exercises. | |||
* Oral aides to assist swallowing eg chewing gum, sucking hard boiled lollie. | |||
* Use of sweat bands on wrist to discretely wipe away saliva. | |||
== Pharmacological Treatment == | |||
The first approach begins by removing medications that aggravate drooling eg. cholinesterase inhibitors, clozapine or quetiapine. Specific treatment options for drooling in PD are both pharmacological and nonpharmacological. | The first approach begins by removing medications that aggravate drooling eg. cholinesterase inhibitors, clozapine or quetiapine. Specific treatment options for drooling in PD are both pharmacological and nonpharmacological. | ||
Treatments are mainly directed at reducing salivary secretion. The groups of medications include anticholinergics, adrenergic receptor antagonists, and botulinum neurotoxin (BoNT). | Pharmacological Treatments are mainly directed at reducing salivary secretion. The groups of medications include anticholinergics, adrenergic receptor antagonists, and botulinum neurotoxin (BoNT). | ||
Local injection with BoNT into major salivary glands is the most effective therapeutic option at present. Developing more precise therapeutic choices would help to enhance patients’ quality of life.<ref name=":1" /> | Local injection with BoNT into major salivary glands is the most effective therapeutic option at present. Developing more precise therapeutic choices would help to enhance patients’ quality of life.<ref name=":1" /> | ||
Revision as of 13:16, 9 November 2023
Original Editor - User Name
Top Contributors - Lucinda hampton
Introduction[edit | edit source]
Drooling in Parkinson’s disease (PD) is an many times disregarded however it is an important non-motor symptom that impacts the patient's quality of life, [1] having negative physical and psychosocial consequences for patients.[2] In relatively advanced patients with PD, drooling occurs in over 30% of patients, with dysphagia occurring with greater frequency in these patients[1]. The precise pathophysiological mechanism of drooling in PD is not clear, however excessive drooling is shown to be associated with higher burdens of non-motor symptoms and greater motor fluctuations of motor symptoms and bradykinesia[3].
Negative Effects[edit | edit source]
Drooling in patients may: cause saliva to spill from their oral cavity: may be aspirated causing aspiration pneumonia; may cause poor oral hygiene and, significantly, social embarrassment.[2]
Objective Measures[edit | edit source]
Drooling screen eg Radboud Oral Motor Inventory for Parkinson’s disease (ROMP)-saliva Assessment
Non-Pharmacological Treatment[edit | edit source]
Include:
- Cues To Swallow, cue them to remember every eg 3 minutes to, such as commands like "gather your saliva in your mouth, tightly close your lips, then swallow".
- Positioning. Posture is important in good swallowing. Work on preventing eg forward head posture which can increase drooling. Teach appropriate seating ergonomics and postural exercises.
- Oral aides to assist swallowing eg chewing gum, sucking hard boiled lollie.
- Use of sweat bands on wrist to discretely wipe away saliva.
Pharmacological Treatment[edit | edit source]
The first approach begins by removing medications that aggravate drooling eg. cholinesterase inhibitors, clozapine or quetiapine. Specific treatment options for drooling in PD are both pharmacological and nonpharmacological.
Pharmacological Treatments are mainly directed at reducing salivary secretion. The groups of medications include anticholinergics, adrenergic receptor antagonists, and botulinum neurotoxin (BoNT).
Local injection with BoNT into major salivary glands is the most effective therapeutic option at present. Developing more precise therapeutic choices would help to enhance patients’ quality of life.[2]
Resources[edit | edit source]
- bulleted list
- x
or
- numbered list
- x
References[edit | edit source]
- ↑ 1.0 1.1 van Wamelen DJ, Leta V, Johnson J, Ocampo CL, Podlewska AM, Rukavina K, Rizos A, Martinez-Martin P, Chaudhuri KR. Drooling in Parkinson’s disease: prevalence and progression from the non-motor international longitudinal study. Dysphagia. 2020 Dec;35:955-61 .Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7669801/ (accessed 9.11.2023)
- ↑ 2.0 2.1 2.2 Srivanitchapoom P, Pandey S, Hallett M. Drooling in Parkinson's disease: a review. Parkinsonism & related disorders. 2014 Nov 1;20(11):1109-18.Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252747/ (accessed 9.11.2023)
- ↑ Polychronis S, Nasios G, Dardiotis E, Messinis L, Pagano G. Pathophysiology and Symptomatology of Drooling in Parkinson’s Disease. InHealthcare 2022 Mar 11 (Vol. 10, No. 3, p. 516). MDPI.Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8951596/ (accessed 9.11.2023)
