A new service aimed at reducing the impact of one of the symptoms of Motor Neurone Disease (MND) is being piloted at The Walton Centre, the country’s only specialist neurosciences NHS Trust.
Swallowing problems, known as dysphagia, affect at least two-thirds of all people with MND during the course of their illness. This can either result in choking and chest infections if food, drink or saliva goes backwards, or drooling if forwards.
As well as significant health consequences, the impact of symptoms like drooling can result in considerable quality of life issues.
Mel Taylor, speech and language therapist at The Walton Centre, said: “Patients who suffer with poor saliva control resulting in drooling can very quickly lose their confidence in public situations, as they don’t want the stigma of being seen drooling. They can also struggle to make phone calls as the phone gets wet, and it becomes very socially isolating.
“From speaking to our patients it’s the issue that concerns them the most, so we really wanted to be able to tackle it as soon as it becomes an issue for them.”

Previously patients were assessed for three different treatments:
· Hyoscine patch – prescribed by a GP, this is stuck onto the skin
· Glycopyrrolate – a drug treatment which needs to be increased through its usage
· Botulinum toxin – injections into salivary glands to reduce saliva production
Currently, patients have to be offered both the patch and drug treatments before being referred for botulinum toxin injections.
Mel said: “It’s a long process, and for many patients those treatments don’t work as well as they would want. Therefore, it just adds to the feeling of social anxiety and isolation for our patients.”
In response, the Walton Centre has developed a new clinic to cut through the three-stage process.
“Patients come to the new clinic as soon as they start to suffer from saliva management issues,” says Mel.
“They’re assessed by myself, a specialist rehabilitation doctor and a respiratory physiotherapist and we carry out tests to check their swallow capability. Then we can make a decision there and then about which is the best option out of the three different kinds of treatment.”
As the only treatment centre for MND in the region, The Walton Centre sees around 200 patients a year. The new clinic is currently seeing both newly diagnosed and existing patients who are still experiencing saliva management problems.
Mel added: “We hope this new clinic will make a real difference, to both the quality of life for our MND patients and the reduction of further health complications from these symptoms.”