Treatment with Weak Electromagnetic Fields Controls Drooling in Parkinson's Disease

Abstract

To the Editor: Drooling has long been recognized a characteristic feature of pos-tencephalitic Parkinsonism and idiopathic Parkinson's disease (PD). James Parkinson's original description of a patient whose “saliva was continually trickling out of his mouth, and he had neither the power of retaining it, nor of spitting it freely” (Parkinson, 1817) implied that drooling is related to dysfunction of swallowing rather than to excessive saliva production (Apenzeller, 1982). Current investigations support this contention, although it remains unknown whether drooling reflects an inability to initiate voluntary oropharyngeal movements or whether it results from loss of unconscious coordinated movements associated with swallowing resulting in inability to dispose of saliva. Drooling is considered a hypokinetic phenomenon more commonly observed in the later stages of the disease (Nutt et al. 2, 1992; Korczyn, 1989). Since drooling can result in considerable social embarrassment, patients often desire treatment of this bothersome complaint. In some cases adjustment of antiParkinsonian medications to decrease oropharyngeal akinesia may control the drooling (Korczyn, 1989). In more resistant cases administration of a peripherally acting antimuscarinic agent such as propantheline (15-45 mg/d, in divided doses) may reduce drooling but the undesirable effects of parasympathetic blockade often limit its use (Tanner et al.

Key Words:

• Parkinson's disease
• salivation
• drooling
• electromagnetic fields