PT - JOURNAL ARTICLE AU - Alexander J McGeachan AU - Christopher J Mcdermott TI - Management of oral secretions in neurological disease AID - 10.1136/practneurol-2016-001515 DP - 2017 Apr 01 TA - Practical Neurology PG - 96--103 VI - 17 IP - 2 4099 - http://pn.bmj.com/content/17/2/96.short 4100 - http://pn.bmj.com/content/17/2/96.full SO - Pract Neurol2017 Apr 01; 17 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.