title: Recurrent jaw dislocation after botulinum toxin treatment for sialorrhoea in amyotrophic lateral sclerosis.
abstract: Botulinum toxin (BTX) has been used successfully to treat various movement disorders, and is increasingly used for many other medical conditions. Sialorrhoea is a disabling symptom in many neurological patients including those with Parkinson's disease, stroke and amyotrophic lateral sclerosis (ALS). BTX has recently been shown to be effective for treating sialorrhoea. We report an ALS patient who developed recurrent jaw dislocation following BTX treatment for sialorrhoea to highlight the observation that intraparotid BTX may be complicated by jaw dislocations in some at-risk ALS patients. Clinicians using BTX to treat sialorrhoea in ALS need to be aware of this potentially serious complication.
authors.affiliation: Department of Neurology, Singapore General Hospital, Outram Road, 169608, Singapore, Singapore. gnrtek@sgh.com.sg
authors.forename: E K
authors.initials: EK
authors.lastname: Tan
authors.forename: Y L
authors.initials: YL
authors.lastname: Lo
authors.forename: A
authors.initials: A
authors.lastname: Seah
authors.forename: A P
authors.initials: AP
authors.lastname: Auchus
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D001905:Botulinum Toxins / Q000009:adverse effects*; D004576:Electromyography; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000009:adverse effects; D004204:Joint Dislocations / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D008410:Masticatory Muscles / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D018908:Muscle Weakness / Q000139:chemically induced / Q000473:pathology / Q000503:physiopathology; D010306:Parotid Gland / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D012798:Sialorrhea / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D013704:Temporomandibular Joint / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D013705:Temporomandibular Joint Disorders / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology
chemical_list: D001905:Botulinum Toxins