Motor neurone disease: assessment and management

Recommendation ID: NG42/4
Question: Saliva:- How is excessive drooling of saliva (sialorrhoea) managed in people with motor neurone disease (MND)?
Any explanatory notes (if applicable): Why this is important:- Sialorrhoea affects up to 50% of people with MND and in 42% of these individuals the symptom is poorly controlled. There is no evidence base for clinicians to make decisions with regards to the treatment options available. Antimuscarinics are used first-line but there is no evidence to inform which antimuscarinic and at what dose. Botulinum toxin is used second- or third-line although there is little evidence to guide dosing, which salivary glands to inject and which type of botulinum toxin to use. Currently there is no baseline information about how specialists are using these treatments and this information is required to inform comparative studies.

Source guidance details

Is this a recommendation for the use of a technology only in the context of research?	No
Is it a recommendation that suggests collection of data or the establishment of a register?	No
Last Reviewed	29/02/2016