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- Title
Botulinum toxin A: a new option for treatment of drooling in children with cerebral palsy. Presentation of a case series.
- Authors
Jongerius, Peter H.; Rotteveel, Jan J.; van den Hoogen, Frank; Joosten, Frank; van Hulst, Karen; Gabreëls, Fons J. M.; Jongerius, P H; Rotteveel, J J; van den Hoogen, F; Joosten, F; van Hulst, K; Gabreëls, F J
- Abstract
<bold>Unlabelled: </bold>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.<bold>Conclusion: </bold>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.
- Subjects
DROOLING; PEDIATRIC therapy; BOTULINUM toxin; THERAPEUTICS; SALIVARY gland diseases; CEREBRAL palsy; INJECTIONS; MUSCLE relaxants; SALIVATION; DISEASE complications
- Publication
European Journal of Pediatrics, 2001, Vol 160, Issue 8, p509
- ISSN
0340-6199
- Publication type
journal article
- DOI
10.1007/s004310100784