Sialorrhea: Less Commonly Addressed Symptom of Patients Presenting with Neurological Disorders in Neurology and Oral Medicine Specialties

Sialorrhea in Motor Neuron Disease

Abstract

Background: Saliva-related challenges significantly impact individuals diagnosed having motor neuron disease (MND). Despite existing clinical guiding principles outlining evaluation and management protocols, research attention towards the management of saliva problems has been limited. Objective: To evaluate physicians' perspectives on sialorrhea as a major concern for patients presenting with neurological disorders in neurology clinics. Study Design: Retrospective hospital-based cross-sectional study. Settings: Department of Oral Medicine, Lahore Medical and Dental College. Neurology departments of various hospitals in Lahore including Lahore General Hospital, Jinnah Hospital and Sharif Medical & Dental College, Lahore Pakistan. Duration: An analysis was conducted on individuals diagnosed with MND between January 2021 and January 2023. Methods: The association between clinical factors and drool matters was scrutinized through univariate and multivariable logistic regression, with outcomes presented as odds ratios and corresponding 95% confidence intervals. Additionally, a survey involving health care authorities responsible for patients with motor neuron disease (pwMND) care was carried out to provide context to the conclusions. Results: 250 individuals with motor neuron disease (pwMND) received a diagnosis, with data on saliva issues available for 125 (50%) through direct questioning. Those without available data on saliva problems were slightly older (mean age 68.0 vs. 65.2 years; p = 0.032), but no significant differences found in terms of gender, location of onset, and MND subtype. Conclusion: Saliva problems are prevalent in individuals with MND. Despite this association, a noteworthy proportion of pwMND encountering drooling did not undergo suggested treatments.