Botulinum toxin type a injections to salivary glands: combination with single event multilevel chemoneurolysis in 2 children with severe spastic quadriplegic cerebral palsy.
We describe 2 children with severe spastic quadriplegic cerebral palsy (CP) who have significant drooling and frequent aspiration pneumonia. They underwent simultaneous botulinum toxin type A (BTX-A) injections to salivary glands for drooling and prevention of aspiration pneumonia along with single-event multilevel chemoneurolysis (SEMLC) with BTX-A and 5% phenol for severe diffuse spasticity. There was significant improvement in drooling, frequency of aspiration pneumonia, and spasticity without adverse effect. BTX-A injections into the salivary glands, in addition to SEMLC, for these 2 children with medically complicated severe spastic quadriplegic CP, were safe and highly successful procedures, which improved their health-related quality of life.
Kim
Heakyung
H
Department of Physical Medicine and Rehabilitation, University of Pennsylvania, School of Medicine, Philadelphia, PA, USA. kimhk@email.chop.edu
Lee
Yung
Y
Weiner
Daniel
D
Kaye
Robin
R
Cahill
Anne Marie
AM
Yudkoff
Marc
M
D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000175:diagnosis / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000503:physiopathology; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D019148:Neuromuscular Blockade / Q000379:methods; D011015:Pneumonia, Aspiration / Q000517:prevention & control; D011782:Quadriplegia / Q000175:diagnosis / Q000188:drug therapy; D018570:Risk Assessment; D012469:Salivary Glands / Q000187:drug effects*; D012472:Salivation / Q000187:drug effects; D012720:Severity of Illness Index; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A