RT Journal Article SR Electronic T1 Management of oral secretions in neurological disease JF Practical Neurology JO Pract Neurol FD BMJ Publishing Group Ltd SP practneurol-2016-001515 DO 10.1136/practneurol-2016-001515 A1 Alexander J McGeachan A1 Christopher J Mcdermott YR 2017 UL http://pn.bmj.com/content/early/2017/02/09/practneurol-2016-001515.abstract AB Sialorrhoea is a common and problematic symptom that arises from a range of neurological conditions associated with bulbar or facial muscle dysfunction. Drooling can significantly affect quality of life due to both physical complications such as oral chapping, and psychological complications such as embarrassment and social isolation. Thicker, tenacious oral and pharyngeal secretions may result from the drying management approach to sialorrhoea. The management of sialorrhoea in neurological diseases depends on the underlying pathology and severity of symptoms. Interventions include anticholinergic drugs, salivary gland-targeted radiotherapy, salivary gland botulinum toxin and surgical approaches. The management of thick secretions involves mainly conservative measures such as pineapple juice as a lytic agent, cough assist, saline nebulisers and suctioning or mucolytic drugs like carbocisteine. Despite a current lack of evidence and variable practice, management of sialorrhoea should form a part of the multidisciplinary approach needed for long-term neurological conditions.