A study of salivary secretion in Parkinson's disease.

Hypersialorrhea is frequently reported in patients with idiopathic Parkinson's Disease (PD). Excessive production of saliva, swallowing difficulties, or both could explain this complaint. Dopamine (DA) has been shown to modulate salivary secretion in a number of vertebrate and invertebrate species. The present study was performed to compare the unstimulated salivary flow in 83 patients with PD (8 untreated and 75 treated with levodopa + DA agonist) and in 65 age- and sex-matched control subjects. The Mann-Whitney U-test showed a significantly lower salivary flow in treated patients with PD (535 +/- 42 mg/2 min) (p < 0.002) and de novo patients (447 +/- 141) (p < 0.03) compared to controls (834 +/- 68 mg/2 min) with no relation with age or sex. Finally, the present study of reduced salivary flow in PD suggests that complaints of hypersialorrhea are not caused by a salivary defect, but could be explained by difficulties in swallowing. The decrease in salivary flow could be explained by autonomic dysfunction in PD.

[Drug-induced hiccup: a review of the France pharmacologic vigilance database]. / Hoquet d'origine médicamenteuse: enquête à partir de la Banque Nationale de Pharmacovigilance.

Hiccup is a sudden contraction of the inspiratory muscles, followed by an abrupt closure of the glottis, thus producing a characteristic sound. Some drugs have been reported to induce hiccup. Using the French Pharmacovigilance Database, the aim of the present study was to investigate reports of such an adverse drug reaction (ADR). Between 1985 and 1997, 53 cases were reported to the French pharmacovigilance network. The sex ratio was 16.6. Mean age was 52 years (range 18-83). Of the total number, 23 per cent were related to corticosteroids. 15 per cent to psychiatric (mainly non-imipraminic antidepressants), 13 per cent to neurologic (mainly dopaminergic antiparkinsonians), 12 per cent to anti-infectious (beta-lactams, macrolides, fluoroquinolones), 7 per cent to cardiovascular (mainly digitalic compounds), 6 per cent to analgesic (opioid drugs), 6 per cent to non-steroidal anti-inflammatory drugs.... Rechallenge was positive in 7 cases. Two cases were 'serious' according to the WHO definition. The diagnosis of drug-induced hiccup is difficult and often achieved only by a process of elimination. The mechanism of this drug-induced ADR remains often not clearly explained.