The use of subcutaneous glycopyrrolate in the management of sialorrhoea and facilitating the use of non-invasive ventilation in amyotrophic lateral sclerosis

Abstract

Sialorrhoea is a recognized complication of bulbar amyotrophic lateral sclerosis (ALS) that leads to an increased risk of potentially harmful aspiration and often prevents patients from tolerating non-invasive ventilation (NIV). A case of treatment-resistant sialorrhoea in bulbar ALS is described where subcutaneous glycopyrrolate was effective without significant side-effects. The patient went on to markedly increase the length of time she could tolerate NIV each night.

Key words::

• Glycopyrrolate
• sialorrhoea
• amyotrophic lateral sclerosis
• non-invasive ventilation

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.