Sialorrhea

Excessive saliva production that may result in drooling or choking if there are impairments to swallowing. Sialorrhea often accompanies neurologic disorders and BRAIN injuries that affect the parasympathetic NERVOUS SYSTEM, which regulates the functions of most of the body’s glands. People who have sialorrhea are at risk for ASPIRATION (inhaling excessive saliva into the airways and LUNGS), choking, INFECTION, and irritation of the SKIN around the face and neck. Sialorrhea also presents significant hygienic concerns and often is embarrassing to the person who has it.

Anticholinergic medications, which “dry out” the body, curtail sialorrhea in many people. These medications also affect neurotransmitters in the brain, however, which can have unintended detrimental effects on motor function. Some people benefit from botulinum toxin A injections (BOTULINUM THERAPY) into the tissues surrounding the salivary glands, which temporarily paralyzes the muscles that release saliva. Other treatment approaches include surgery to remove or obstruct portions of the submandibular salivary glands, which produce about 80 percent of the saliva, and therapy to improve muscle control and swallowing ability. Treatment success depends on the underlying causes.