Diurnal and nocturnal drooling in Parkinson's disease.
SourceJournal of Neurology, 259, 1, (2012), pp. 119-23
01 januari 2012
Article / Letter to editor
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Journal of Neurology
SubjectDCN 2: Functional Neurogenomics NCEBP 10: Human Movement & Fatigue; DCN MP - Plasticity and memory NCEBP 10: Human Movement & Fatigue; DCN MP - Plasticity and memory NCEBP 4 - Quality of hospital and integrated care; NCEBP 10: Human Movement & Fatigue DCN PAC - Perception action and control; NCEBP 6: Quality of nursing and allied health care
Drooling as symptom of Parkinson's disease (PD) has thus far been poorly defined. This uncertainty is reflected by high variations in published prevalence rates. The aim of this study was to investigate the prevalence of saliva loss versus accumulation of saliva as a possible preliminary stage, and diurnal drooling versus nocturnal drooling. In addition, we evaluated the association between drooling severity and the severity of facial and oral motor disorders. We collected age, disease duration, UPDRS III and Hoehn & Yahr stage from 104 consecutive outpatients with PD. Diurnal and nocturnal drooling was evaluated with a validated questionnaire (ROMP-saliva). A speech pathologist, blinded for drooling severity, rated facial expression, involuntary mouth opening and difficulty with nose breathing and also interviewed patients about sleeping position and nose-breathing during the night. Thirty patients (29%) had no complaints with saliva control ('non-droolers'), 45 patients (43%) experienced accumulation of saliva or only nocturnal drooling ('pre-droolers'), and 29 (28%) had diurnal drooling (24 of which also drooled during the night; 'droolers'). The droolers had longer disease duration (10 vs. 7 years, p = 0.01) and drooling was independently associated with involuntary mouth opening (OR = 2.0; 95% CI 1.02-3.99) and swallowing complaints (OR = 1.2; 95% CI 1.03-1.31). Diurnal drooling-defined as dribbling of saliva while awake-is present in about 28% of PD patients. This is less than usually reported. Diurnal drooling typically appeared later in the disease course. The association with oral motor behavior should encourage the development of behavioral treatment approaches.
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- Faculty of Medical Sciences 
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