Objective: To study the frequency of drooling complaints in Parkinson’s disease (PD) patients during outpatient visits.

Background: Sialorrhea (excessive drooling) is a non-motor symptom of PD that can lead not only to local complications but also contributes to the development of respiratory infections due to saliva aspiration. Furthermore, this symptom has an extremely negative impact on patients’ quality of life, which significantly worsens the prognosis and complicates patient rehabilitation.

Despite this, the symptom remains under-recognized by both physicians and patients.

Method: The study involved 89 PD patients (mean age 68.67 ± 8.14 years; mean disease duration 5.35 ± 3.54 years). The presence and severity of sialorrhea were assessed using a proprietary questionnaire. Additionally, the reasons why patients did not actively complain about drooling, despite its presence, were investigated.

Results: Only 15.7% of PD patients actively complained of drooling, while 84.3% did not report it initially. Upon active questioning, 53.3% admitted to experiencing increased drooling. A survey on the reasons for not complaining revealed: 45% of respondents considered the severity of motor PD symptoms more significant than drooling; 32.5% did not think this symptom could be related to PD; 15% did not believe it was appropriate to mention this complaint to a neurologist; and 7.5% did not think this symptom could or should be treated.

Conclusion: Sialorrhea in PD remains under-recognized by both physicians and patients.

The use of incobotulinumtoxin A (Xeomin) for sialorrhea treatment is currently a first-line therapy with the highest class of evidence. Low awareness among neurologists and patients themselves creates a barrier to accessing this effective treatment method.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/diagnosis-and-therapeutic-approaches-for-sialorrhea-in-patients-with-parkinsons-disease/