By Dan Longo, Anthony Fauci
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Sugarless mints or chewing gum may stimulate salivary secretion if dysfunction is mild. When sufficient exocrine tissue remains, pilocarpine or cevimeline has been shown to increase secretions. Commercial saliva substitutes or gels relieve dryness but must be supplemented with fluoride applications to prevent caries. Sialolithiasis presents most often as painful swelling but in some instances as just swelling or pain. The obstructing stone produces spasm upon eating. Conservative therapy consists of local heat, massage, and hydration.
Cerebral palsy 3. Rabies, tetanus, neurosyphilis 4. Cerebrovascular disease 5. Parkinson’s disease and other extrapyramidal lesions 6. Multiple sclerosis (bulbar and pseudobulbar palsy) 7. Amyotrophic lateral sclerosis (motor neuron disease) 8. Poliomyelitis and post-poliomyelitis syndrome II. Diseases of cranial nerves (V, VII, IX, X, XII) A. Basilar meningitis (chronic inflammatory, neoplastic) B. Nerve injury C. Neuropathy (Guillain-Barré syndrome, familial dysautonomia, sarcoid, diabetic and other causes) III.
38 ■ Further Readings . . . . . . . . . . . . . . . . . 41 This is supported by electroencephalographic studies showing activation of temporofrontal cortical regions during nausea. Nausea is the subjective feeling of a need to vomit. Vomiting is contrasted with regurgitation, the effortless passage of gastric contents into the mouth. Rumination is the repeated regurgitation of stomach contents, which may be rechewed and reswallowed. In contrast to vomiting, these phenomena often exhibit volitional control.