Hiccups, Hypersalivation, Hallucinations in Parkinson’s Disease: New Insights, Mechanisms, Pathophysiology, and Management
Parkinson’s disease (PD) is a chronic, progressive neurological disorder and the second most common neurodegenerative condition. We report three common but overlooked symptoms in PD—hiccups, hypersalivation, and hallucinations—in terms of their prevalence, pathophysiology, and up-to-date evidence-ba...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/13/5/711 |
| _version_ | 1797599523956064256 |
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| author | Vinod Metta Guy Chung-Faye Hani TS Benamer Rukmini Mrudula Vinay Goyal Cristian Falup-Pecurariu Neha Muralidharan Desh Deepak Mohammed Abdulraheem Rupam Borgohain Kallol Ray Chaudhuri |
| author_facet | Vinod Metta Guy Chung-Faye Hani TS Benamer Rukmini Mrudula Vinay Goyal Cristian Falup-Pecurariu Neha Muralidharan Desh Deepak Mohammed Abdulraheem Rupam Borgohain Kallol Ray Chaudhuri |
| author_sort | Vinod Metta |
| collection | DOAJ |
| description | Parkinson’s disease (PD) is a chronic, progressive neurological disorder and the second most common neurodegenerative condition. We report three common but overlooked symptoms in PD—hiccups, hypersalivation, and hallucinations—in terms of their prevalence, pathophysiology, and up-to-date evidence-based treatment strategies. Whilst all these three symptoms do occur in many other neurological and non-neurological conditions, early recognition and treatment are paramount. Whilst hiccups affect 3% of healthy people, their rate of occurrence is higher (20%) in patients with PD. Hypersalivation (Sialorrhea) is another common neurological manifestation of many neurological and other neurodegenerative conditions such as motor neuron disease (MND), with a median prevalence rate of 56% (range: 32–74%). A 42% prevalence of sialorrhea is also reported in sub-optimally treated patients with PD. Hallucinations, especially visual hallucinations, are commonly reported, with a prevalence of 32–63% in PD, and a 55–78% prevalence is noted in patients with dementia with Lewy bodies (DLB), followed by tactile hallucinations, which are indicated by a sensation of crawling bugs or imaginary creatures across the skin surface. Whilst mainstay and primary management strategies for all these three symptoms are carried out through history taking, it is also essential to identify and treat possible potential triggers such as infection, minimise or avoid causative (such as drug-induced) factors, and especially carry out patient education before considering more definitive treatment strategies, such as botulinum toxin therapies for hypersalivation, to improve the quality of life of patients. This original review paper aims to provide a comprehensive overview of the disease mechanisms, pathophysiology, and management of hiccups, hypersalivation, and hallucinations in Parkinson’s disease. |
| first_indexed | 2024-03-11T03:35:42Z |
| format | Article |
| id | doaj.art-9f22d54dd8274a3c8aff235eb51f2305 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-11T03:35:42Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-9f22d54dd8274a3c8aff235eb51f23052023-11-18T02:03:02ZengMDPI AGJournal of Personalized Medicine2075-44262023-04-0113571110.3390/jpm13050711Hiccups, Hypersalivation, Hallucinations in Parkinson’s Disease: New Insights, Mechanisms, Pathophysiology, and ManagementVinod Metta0Guy Chung-Faye1Hani TS Benamer2Rukmini Mrudula3Vinay Goyal4Cristian Falup-Pecurariu5Neha Muralidharan6Desh Deepak7Mohammed Abdulraheem8Rupam Borgohain9Kallol Ray Chaudhuri10Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson’s Foundation Centre of Excellence, King’s College Hospital, King’s College London, London WC2R 2LS, UKDepartment of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson’s Foundation Centre of Excellence, King’s College Hospital, King’s College London, London WC2R 2LS, UKDepartment of Movement Disorders & Parkinson’s Centre of Excellence, Mohammed Bin Rashid University, Dubai 263267, United Arab EmiratesCNC Institute of Movement Disorders & Parkinson’s Centre of Excellence, IndiaInstitute of Movement Disorders, Medanta Hospitals, IndiaDepartment of Neurology, Transilvania University Brasov, 500001 Brașov, RomaniaKings College Hospital London, Dubai 263267, United Arab EmiratesKings College Hospital London, Dubai 263267, United Arab EmiratesKings College Hospital London, Dubai 263267, United Arab EmiratesCNC Institute of Movement Disorders & Parkinson’s Centre of Excellence, IndiaDepartment of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson’s Foundation Centre of Excellence, King’s College Hospital, King’s College London, London WC2R 2LS, UKParkinson’s disease (PD) is a chronic, progressive neurological disorder and the second most common neurodegenerative condition. We report three common but overlooked symptoms in PD—hiccups, hypersalivation, and hallucinations—in terms of their prevalence, pathophysiology, and up-to-date evidence-based treatment strategies. Whilst all these three symptoms do occur in many other neurological and non-neurological conditions, early recognition and treatment are paramount. Whilst hiccups affect 3% of healthy people, their rate of occurrence is higher (20%) in patients with PD. Hypersalivation (Sialorrhea) is another common neurological manifestation of many neurological and other neurodegenerative conditions such as motor neuron disease (MND), with a median prevalence rate of 56% (range: 32–74%). A 42% prevalence of sialorrhea is also reported in sub-optimally treated patients with PD. Hallucinations, especially visual hallucinations, are commonly reported, with a prevalence of 32–63% in PD, and a 55–78% prevalence is noted in patients with dementia with Lewy bodies (DLB), followed by tactile hallucinations, which are indicated by a sensation of crawling bugs or imaginary creatures across the skin surface. Whilst mainstay and primary management strategies for all these three symptoms are carried out through history taking, it is also essential to identify and treat possible potential triggers such as infection, minimise or avoid causative (such as drug-induced) factors, and especially carry out patient education before considering more definitive treatment strategies, such as botulinum toxin therapies for hypersalivation, to improve the quality of life of patients. This original review paper aims to provide a comprehensive overview of the disease mechanisms, pathophysiology, and management of hiccups, hypersalivation, and hallucinations in Parkinson’s disease.https://www.mdpi.com/2075-4426/13/5/711Parkinson’s diseasehiccupshypersalivationhallucinationsbotulinum toxin |
| spellingShingle | Vinod Metta Guy Chung-Faye Hani TS Benamer Rukmini Mrudula Vinay Goyal Cristian Falup-Pecurariu Neha Muralidharan Desh Deepak Mohammed Abdulraheem Rupam Borgohain Kallol Ray Chaudhuri Hiccups, Hypersalivation, Hallucinations in Parkinson’s Disease: New Insights, Mechanisms, Pathophysiology, and Management Journal of Personalized Medicine Parkinson’s disease hiccups hypersalivation hallucinations botulinum toxin |
| title | Hiccups, Hypersalivation, Hallucinations in Parkinson’s Disease: New Insights, Mechanisms, Pathophysiology, and Management |
| title_full | Hiccups, Hypersalivation, Hallucinations in Parkinson’s Disease: New Insights, Mechanisms, Pathophysiology, and Management |
| title_fullStr | Hiccups, Hypersalivation, Hallucinations in Parkinson’s Disease: New Insights, Mechanisms, Pathophysiology, and Management |
| title_full_unstemmed | Hiccups, Hypersalivation, Hallucinations in Parkinson’s Disease: New Insights, Mechanisms, Pathophysiology, and Management |
| title_short | Hiccups, Hypersalivation, Hallucinations in Parkinson’s Disease: New Insights, Mechanisms, Pathophysiology, and Management |
| title_sort | hiccups hypersalivation hallucinations in parkinson s disease new insights mechanisms pathophysiology and management |
| topic | Parkinson’s disease hiccups hypersalivation hallucinations botulinum toxin |
| url | https://www.mdpi.com/2075-4426/13/5/711 |
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