What is the role of antisialorrhea medications in the treatment of amyotrophic lateral sclerosis (ALS)?

Updated: Nov 13, 2019
  • Author: Kathleen Clem, MD, FACEP; Chief Editor: Andrew K Chang, MD, MS  more...
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Answer

Answer

Sialorrhea, or drooling, is embarrassing and is associated with aspiration pneumonia. The prevalence for patients with ALS is 50%. Anticholinergic medications are generally tried first to reduce sialorrhea, although effectiveness is unproven. [5]

In October 2009, the American Academy of Neurology (AAN) published a 2-part, evidence-based practice parameter update about the care of the patient with ALS. [6, 7] The practice parameter recommended that botulinum toxin B (rimabotulinumtoxinB [Myobloc]) be considered for the treatment of refractory sialorrhea and that low-dose radiation therapy to the salivary glands be considered as well. [8]


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