Patient description: A 5-year-old boy presents to the emergency department with complaints of progressively worsening dysphagia, drooling, fever and vocal changes. He is toxic-appearing, and leans forward while sitting on his mother's lap. He is drooling and speaks with a muffled "hot potato" voice. The parents deny the possibility of foreign body ingestion or trauma, and they report that they are delaying some of his vaccines.

Clinical trial eligibility criteria: eligible ages (years): 3.0-18.0,  Cerebral Palsy Neurological Conditions Mental Retardation Sialorrhea To be included in this study, patients must meet the following Male or female, weighing at least 13 kilograms (27 pounds), aged 3 through 18 years Diagnosis of cerebral palsy and/or mental retardation or any other neurologic impairment or condition (cognitively capable and cognitively impaired patients may be enrolled) Chronic drooling in the absence of treatment to the extent that the chin or clothing becomes wet on most days by confirming the Modified Teacher's Drooling Scale score ≥ 5 Must be living in a situation where reliable parents/caregivers are willing and capable of administering medications, as determined by the investigator Written informed consent signed by the parent or legally acceptable representative Written assent signed by the age-appropriate patient if mentally capable, as determined by the investigator, and required by the site's Institutional Review Board If female of childbearing potential, the patient must have a negative pregnancy test at screening and Visit 2 If female of childbearing potential and sexually active, she must use a medically acceptable form of contraception  Patients are excluded from this study if they meet any of the following Patients who used glycopyrrolate within approximately 24 hours prior to the start of the baseline period, which began on Day -2 Patients who used prohibited medications within 5 plasma half-lives of the medication prior to the start of the baseline period Patients injected with intrasalivary gland botulinum toxin within 10 months prior to the start of the baseline period Patients using intraoral devices or prosthetics for the treatment of drooling within 1 week prior to the start of the baseline period Patients receiving acupuncture for the treatment of drooling or who have received acupuncture for the treatment of drooling within 3 months prior to the start of the baseline period Patients who have medical conditions contraindicating anticholinergic therapy including gastrointestinal reflux, narrow-angle glaucoma, obstructive uropathy, obstructive disease of the gastrointestinal tract (i.e., delayed gastric emptying, pyloroduodenal stenosis, etc.), paralytic ileus, intestinal atony, vesicoureteral reflux, reactive airway disease, myasthenia gravis, hyperthyroidism, cardiac arrhythmias and/or tachycardia, and/or clinically significant electrocardiogram abnormalities, as determined by the investigator Patients who have a known contraindication to the study medication, including allergy to the study medication or any of its components Patients who have poorly controlled seizures defined as daily seizures Patients who have a history of obstructive disease of the gastrointestinal tract (i.e., intestinal obstruction)