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Drooling and dysphagia in Parkinson's disease — DGM MCQ

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HardMovement disordersDrooling and dysphagia in Parkinson's diseaseDGM

An 86-year-old woman with Parkinson's disease has drooling and coughing during meals. She has mild cognitive impairment and recurrent chest infections. Her carer asks for tablets to dry secretions. What is the most appropriate management?

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Correct answer: E — Speech and language therapy assessment before anticholinergic treatment

NICE recommends speech and language therapy for swallowing and saliva problems in Parkinson's disease, with caution about cognitive adverse effects from anticholinergics. Hyoscine can worsen confusion, constipation and urinary retention. Drooling may reflect impaired swallowing rather than excessive saliva production.

Reference: NICE NG71