Salivation after stroke (
The most common cause of post-stroke sialorrhea is related to the neurological impairment that involves either an inability to retain saliva within the mouth secondary to poor orofacial muscular control and/or dysphagia leading to excess pooling of saliva in the anterior oral cavity [2,3].
Despite intensive medical care, many of the complaints directly threatening the patient's life marginalize their dental needs after the stroke. Recent studies indicate reduced saliva secretion in stroke patients in addition to the increased incidence of caries and periodontal disease.
Botulinum toxin (Botox) injections have been used to treat drooling in people with neurological disorders.
Any neurologic or muscular damage along the deglutitive axes can cause dysphagia. Thus, central causes of dysphagia in stroke patients include damage to the cortex or brain stem, and peripheral causes include damage to the nerves or muscles involved in swallowing.
Dysphagia affects more than 50% of stroke survivors. Fortunately, the majority of these patients recover swallowing function within 7 days, and only 11-13% remain dysphagic after 6 months. One study reported that 80% of patients with prolonged dysphagia required alternative means of enteral feeding.
Swallowing problems can get better, and most people are able to swallow safely again within the first few weeks. A small number of people have problems that last longer than this. Only a very small number of people are left with lasting difficulties.
Severe or chronic drooling can lead to health problems. For example, excessive drooling can cause angular cheilitis — a skin condition characterized by painful, cracked sores at the corners of your mouth. In some cases, excess saliva can even be aspirated into your lungs, causing pneumonia.
Sialorrhoea is a frequent symptom of neurological diseases (e.g. Parkinson's disease, motor neuron disease, cerebral palsy, and stroke) and is defined as excessive saliva accumulation leading to unintentional loss of saliva from the mouth.
Don't give the person anything to eat or drink.
Stroke can cause difficulty with muscle control, including the ability to swallow. “If someone is having a stroke, there is a significant chance of an increased choking hazard,” says Cramer. Even water can be dangerous in this situation.
Salivation after stroke (sialorrhea, hypersalivation, ptyalism) can be caused by the overproduction or a lack of utilization of saliva. Patients after stroke often have sialorrhea as a result of dysphagia. Neurogenic dysphagia in acute period after stroke occurs in 25-65% of patients.
There may also be tingling in the affected area. Sudden confusion, trouble speaking or understanding. Sometimes weakness in the muscles of the face can cause drooling.
Possible Oral Complications of Stroke
People who are recovering from stroke may be more susceptible to dental problems. With facial paralysis, it's easier for food to get trapped between teeth without realizing it. Paralyzed muscles can also lead to poor-fitting dentures, which can irritate gums.
Salivation or saliva production by the submandibular, sublingual, and parotid glands is controlled by the activity of neurons of the salivatory nuclei located near the dorsal pontomedullary junction.
Some people with drooling problems are at increased risk of breathing saliva, food, or fluids into the lungs. This may cause harm if there is a problem with the body's normal reflexes (such as gagging and coughing).
In older people, frequent drooling may be a sign that your muscle control in your mouth and neck is weakening.
Excessive drooling, called sialorrhea, is a common symptom of Parkinson's disease (PD) and can cause awkwardness in social situations.
Individuals who lose saliva through drooling have an enhanced risk of dehydration. The rate of fluid loss can be enhanced, sometimes dangerously, by vomiting, diarrhea and excessive sweating. When a person complains of thirst, he/she may already be mildly dehydrated.
To recap, your best choices are hydrating beverages that contain minimal calories, sugar or salt. Reach for water, coffee or tea most often. And keep a water bottle handy – the visual cue reminds you to keep sipping.
You should limit sweets, cakes, biscuits and processed and fatty meats. It's important to also switch the saturated fats in your diet for unsaturated fats and to reduce your salt intake by avoiding high-salt foods like processed meats, salty snacks and ready-made soups, as well as not adding salt to foods.
No two strokes are the same. Some people may feel more like themselves within just a few days, without any lasting physical or cognitive issues. But for others, it may take several months to heal or adjust to any long-term effects.
The most rapid recovery usually occurs during the first three to four months after a stroke, but some survivors continue to recover well into the first and second year after their stroke. Some signs point to physical therapy.
Stage 1: Flaccidity
The first stage in Brunnstrom's Approach is the initial period of shock immediately after stroke where flaccid paralysis sets in. Flaccid paralysis (flaccidity) is the medical term for a complete lack of voluntary movement.