A food bolus obstructing the oesophagus in a patient with infantile cerebral palsy

Introduction: A foreign body (FB) in the upper aerodigestive tract is a fairly common encounter.Fish bones are the commonest FB seen in adults. The commonest presentation is odynophagia.Usually, the patient will point at the level of FB on the neck to indicate the location.Methods: Clinical report.Results: This case report describes a large FB in an adult with underlying infantile cerebral palsy.Besides dysphagia, it was associated with drooling of saliva and pain in the throat region.Conclusion: FB ingestion with complete obstruction of the oesophagus is an emergency. It maycause total dysphagia as the passage of food is completely blocked.

Exemplification of Medical Cases of Treatment for Hypersalivation Syndrome Through Common Therapy on Spleen and Kidney / 中国中医药信息杂志

The basic pathogenesis of hypersalivation syndrome is the deficiency of spleen and kidney, which results in the imbalance of water metabolism and intake disorder. There are two different characters included in polysialia and profuse spittle. Therefore, dialectics should start from the spleen and kidney, and warming yang and resolving dampness, strengthening spleen and reinforcing kidney should be the treatment. Two medical cases for the treatment of hypersalivation syndrome were illustrated in this article. Lizhong Decoction and Linggui Zhugan Decoction were the basic prescriptions, and combined with the Chinese materia medica with the function of reinforcing kidney andintaking the saliva, with obvious efficacy.

Effect of Scopolamine Butylbromide on Clozapine-induced Hypersalivation in Schizophrenic Patients: A Case Series

Clozapine has been demonstrated to be useful for treating refractory schizophrenia. However, hypersalivation occurs in 31.0-97.4% of the patients treated with clozapine. Accordingly, some patients who are disturbed by their hypersalivation refuse to continue with clozapine treatment. This study investigated the efficacy of the anticholinergic agent scopolamine butylbromide against clozapine-induced hypersalivation. Five schizophrenia patients were coadministered scopolamine butylbromide (30-60 mg/day) for 4 weeks. At the baseline and after 4 weeks' treatment, we subjectively evaluated hypersalivation using a visual analog scale and objectively assessed it using the Drooling Severity Scale and Drooling Frequency Scale. As a result, improvements in the patients' Drooling Severity Scale and Drooling Frequency Scale scores, but no improvements in their visual analog scale scores, were observed after scopolamine butylbromide treatment. These results indicate that at least some schizophrenic patients with clozapine-induced hypersalivation would benefit from scopolamine butylbromide treatment. We conclude that clozapine-induced hypersalivation is one factor of stress to patients. Subjective hypersalivation was not improved, but objective hypersalivation was, by scopolamine butylbromide treatment. However, scopolamine butylbromide and clozapine possess anticholinergic effects so clinicians should closely monitor patients who take scopolamine butylbromide.

Clonidine Treatment of Clozapine-Induced Hypersalivation

BACKGROUND: Hypersalivation can be a troublesome side effect of clozapine, limiting its usefulness in the management some cases of schizophrenia. But the pharmacodynamic basis of clozapine-induced hypersalivation remains obscure. Object : The aim of this study was to evaluate the effect of the alpha2-adrenergic agonist clonidine on clozapin-induced hypersalivation in the patients who were receiving clozapine. METHOD: Twenty one schizophrenic inpatients on clozapine participated in the study. The amount of saliva was measur on the 7th day at 8pm after starting clozapine treatment. Of them, 15 patients who had experienced hypersalivation treated with 0.1mg/day of clonidine. RESULT: Of 21 schizophrenic patients treated with clozapine in the psychiatric inpatients clinic, 15(71.4%) complain hypervalivation. After clonidine treatment, mean salivary flow-rate was decreased significantly in these patients. CONCLUSION: Clozapine-induced hypersalivation could be decreased by administration of alpha2-adrenergic agonist clonidine are compliance could be improved. Also our study supports the notion that increased adrenergic tone contributes to clozapine induce hypersalivation.