The Wenckebach phenomenon associated with sialorrhoea.

Case Report A 23-year-old African male labourer stated that for the previous two years he had been troubled by periods of excessive salivation. These periods varied from a few days to several weeks with symptom-free intervals of similar duration. This excessive salivation necessitated the frequent use of a handkerchief, and on awakening, his pillow was often wet. There were no other symptoms. He had never experienced any syncopal attacks, nor was he prone to palpitations. He had no exertional dyspncea and was able to complete a day of strenuous manual labour without discomfort. There was no history of rheumatic fever and he had not been taking drugs. Physical examination showed a well nourished man. His blood pressure was 120/75 mm. Hg. Apart from occasional dropped beats detected at the pulse and on cardiac auscultation, there were no other abnormalities. Full blood count and sedimentation rate were normal. C-reactive protein was absent. Oral glucose tolerance curve showed a tendency to rebound hypoglycaemia: Fasting specimen-67 mg. per 100 ml. Post ingestion specimens: i, 1, 14, 2, 3, 3j, 4, 5, 51, and 6 hours were, 126, 160, 127, 105, 65,43, 50, 73, 75, and 77 mg. per 100 ml. Teleradiogram and fluoroscopy revealed a normal heart shadow and normal lung fields. Electrocardiograms showed the varying type of Wenckebach phenomenon (see Fig. 1, 2, and 3). Complete relief of the sialorrhcea was afforded by the oral administration of tincture of belladonna, 10 minims thrice daily.