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Botulinum toxin is a useful treatment in excessive drooling of saliva
  3. P BROWN
  1. Institute of Neurology, Queen Square
  2. London, UK
  1. Dr Kailash P Bhatia, University Department of Clinical Neurology, Institute of Neurology, Queen Square, London WC1N 3BG, UK. Tel 0044 171 837 3611 extention 4228; fax 0044 171 278 5616; email HYPERLINK mailto:K.Bhatia{at}

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Excessive drooling of saliva or hypersialorrhea is a common problem in neurodegenerative disorders such as motor neuron disease or Parkinson′s disease. It is usually caused by swallowing dysfunction and can facilitate choking, aspiration, and chest infections. Socially it is embarrassing and disabling. There are not many treatment options. Anticholinergic drugs are sometimes tried but are usually of little benefit and side effects (orthostatic hypotension, dizziness, and mental confusion, particularly in the elderly) limit their usefulness.

Occasionally, as a more drastic treatment irradiation of the parotid gland is carried out when hypersialorrhea becomes intractable.

Apart from its established usefulness in dystonia, spasticity and strabismus there are some data showing that …

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