Oral choline in cerebellar ataxia.

days after the onset of symptoms showed a large, superficial ulcer in the mid-oesophagus.She responded well to withdrawal of emepronium bromide and to oral analgesics and nine days later repeat oesophagoscopy showed that the ulcer had healed.There have been a number of reports of oesophageal ulceration with emepronium bromide,'-4 as well as a report of mouth ulcers,; thought to be caused by prolonged contact of the tablet with the mucosa.The data sheet on this drug now suggests that the tablets should be swallowed with a glass of water, but it is apparent that this instruction is not always stressed by the doctor or followed by the patient.The tablet is formulated to distintegrate rapidly on contact with water but its hygroscopic nature can cause it to stick to the oesophageal mucosa if it is swallowed with too little water.Perhaps the time has come for the manufacturers to redevelop the presen- tation of this drug.Surely it will not be long before oesophageal perforation due to emepronium bromide is recorded.