External radiation of the parotid glands significantly reduces drooling inpatients with motor neurone disease with bulbar paresis

The parotid glands and part of the submandibular glands were irradiated in 18 amyotrophic lateral sclerosis patients with very advanced disease and se vere drooling problems. In a prospective study, a single dosage of 7.0-7.5 Gy was administered bilateral to the larger part of the parotid glands and the posterior parts of the submandibular glands. Salivary secretion rate wa s assayed before and after radiotherapy. Sixteen out of eighteen patients r eported satisfactory to good reduction in drooling lasting up to 4-6 months , 1/18 developed xerostomia and needed saliva substitutes, and 1/18 reporte d no effect. Caregivers reported positive effect in all patients. The proce dure was well tolerated with few side effects. Low dosage external radiothe rapy of the salivary glands is effective in reducing drooling satisfactoril y in ALS patients, especially in well-hydrated patients. (C) 2001 Elsevier Science B.V. All rights reserved.