Treatment
Once visual loss has occurred, it becomes more problematic, but there are reports of recovered vision if blood transfusions and agents that raise blood pressure are administered within hours. A-PION
If a diagnosis of GCA is suspected, treatment with steroids should begin immediately. A sample (biopsy) of the temporal artery should be obtained to confirm the diagnosis and guide future management, but should not delay initiation of treatment. Treatment does not recover lost vision, but prevents further progression and second eye involvement. High dose corticosteroids may be tapered down to low doses over approximately one year. Perioperative
Rapid blood transfusions, to correct anemia and raise blood pressure, may improve PION outcomes. In one report of a related disease, hypotension-induced AION, 3 out of 3 patients who received rapid transfusions reported partial recovery of vision. While rapid transfusions offer some hope, the prognosis for perioperative PION remains poor. Prevention remains the best way to reduce PION. One retrospective report proposes that incidence of PION could be reduced in high-risk cases by altering surgical management. For example, for patients undergoing spine surgery, measures could be taken to minimize intraoperative hypotension, to accelerate the process of blood replacement, and to aggressively treat facial swelling. Epidemiology
PION most commonly affects the elderly.
Hypersalivation, or ptyalism, also known as sialorrhea or hypersialosis is the excessive production of saliva. It has also been defined as increased amount of saliva in the mouth, which may also be caused by decreased clearance of saliva.Hypersalivation can contribute to drooling if there is an inability to keep the mouth closed or difficulty in swallowing (dysphagia) the excess saliva, which can lead to excessive spitting. Hypersalivation also often precedes emesis (vomiting), where it accompanies nausea (a feeling of needing to vomit). Causes
Excessive production
Conditions that can cause saliva overproduction include:
Rabies
Pellagra (niacin or Vitamin B3 deficiency)
Gastroesophageal reflux disease, in such cases specifically called a water brash (a loosely defined lay term), and is characterized by a sour fluid or almost tasteless saliva in the mouth
Gastroparesis (main symptoms are nausea, vomiting, and reflux)
Pregnancy
Fluoride therapy
Excessive starch intake
Anxiety (common sign of separation anxiety in dogs)
Pancreatitis
Liver disease
Serotonin syndrome
Mouth ulcers
Oral infections
Sjögren syndrome (an early symptom in some patients)Medications that can cause overproduction of saliva include:
aripiprazole
clozapine
pilocarpine
ketamine
potassium chlorate
risperidone
pyridostigmineSubstances that can cause hypersalivation include:
mercury
copper
organophosphates (insecticide)
arsenic
nicotine
thallium

Decreased clearance
Causes of decreased clearance of saliva include:
Infections such as tonsillitis, retropharyngeal and peritonsillar abscesses, epiglottitis and mumps. Problems with the jaw, e.g., fracture or dislocation
Radiation therapy
Neurologic disorders such as Amyotrophic lateral sclerosis, myasthenia gravis, Parkinsons disease, multiple system atrophy, rabies, bulbar paralysis, bilateral facial nerve palsy, and hypoglossal nerve palsy

Treatment
Hypersalivation is optimally treated by treating or avoiding the underlying cause.