Botulinum toxin A: a new option for treatment of drooling in children with cerebral palsy. Presentation of a case series.

Abstract

UNLABELLED:

Drooling beyond the age of 4 years is pathological, particularly if it occurs in children with neurological and developmental impairment and disability. Considering the therapeutic spectrum of botulinum toxin A and in view of the innervation of the salivary glands, we postulated that intraglandular injections into the submandibular glands with botulinum toxin A could reduce the secretion of saliva and consequently decrease drooling. Three patients with cerebral palsy and severe drooling were selected and evaluated over a 4-month period. Under ultrasound guidance, one dose of botulinum toxin A was injected bilaterally into the submandibular glands. Saliva secretion was measured at baseline and repeated four times during the following 4 months. In the three patients, maximal salivary flow rate of the sublingual and submandibular glands was reduced by 51% to 63%. The time of the maximal effect differed among the three children. The parents reported a satisfactory reduction of drooling throughout the whole study period. No objectionable disturbances of oral functions were observed. There was mild transient thickening of saliva in one of the patients.

CONCLUSION:

The application of botulinum toxin A to the submandibular gland is a promising technique to reduce salivary flow rate and probably an alternative in the treatment of drooling in children with cerebral palsy.

• Authors: P H Jongerius, J J Rotteveel, F van den Hoogen, F Joosten, K van Hulst, F J Gabreëls
• Journal: European journal of pediatrics (Eur J Pediatr) Vol. 160 Issue 8 Pg. 509-12 (Aug 2001) ISSN: 0340-6199 [Print] Germany
• PMID: 11548191 (Publication Type: Journal Article)

Chemical References

• Neuromuscular Agents
• Botulinum Toxins, Type A

Topics

• Adolescent
• Botulinum Toxins, Type A (administration & dosage, therapeutic use)
• Cerebral Palsy (complications)
• Child
• Female
• Humans
• Injections, Intralesional
• Male
• Neuromuscular Agents (administration & dosage, therapeutic use)
• Salivation (drug effects)
• Sialorrhea (drug therapy, etiology)