title: Drooling in children with cerebral palsy: effect of salivary flow reduction on daily life and care.
abstract: The purpose of this study was to investigate the effect of salivary flow reduction on daily life and provision of care in children with cerebral palsy (CP). Parents of children with CP were asked to fill in a questionnaire on the impact of drooling on the daily life of their children and their families and the data were then analyzed. Forty-five children with severe drooling (28 males, 17 females; mean age 9y 5mo [SD 3y 7mo]; range 3 to 16y) were monitored before and after receiving medication (scopolamine and botulinum toxin) to reduce salivary flow. Type of CP included hypotonia (n = 1), spastic paresis (n = 27), and mixed motor disorders with spastic and dyskinetic paresis (n = 17). Eight children were independently ambulant and 37 children were wheelchair users. Thirty-four children had learning disability with a developmental age of below 6 years. Six participants dropped out of the study; data on 39 children were analyzed. Results showed that anticholinergic agents effectively reduced salivary flow. Drooling diminished substantially and this was accompanied by a significant reduction in care needs, making daily care less demanding. The amount of reported damage to communication devices and computers decreased. In addition to the evaluation of primary variables, such as the salivary flow rate, investigation of impact of drooling on daily life provides useful information about the outcome of treatment for reduction in drooling.
authors.affiliation: Sint Maartenskliniek, Rehabilitation Centre, Nijmegen, the Netherlands.
authors.forename: Jan J W
authors.initials: JJ
authors.lastname: Van der Burg
authors.forename: Peter H
authors.initials: PH
authors.lastname: Jongerius
authors.forename: Karen
authors.initials: K
authors.lastname: Van Hulst
authors.forename: Jacques
authors.initials: J
authors.lastname: Van Limbeek
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Rotteveel
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications* / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D011788:Quality of Life; D012472:Salivation / Q000187:drug effects; D012601:Scopolamine / Q000627:therapeutic use*; D012656:Self-Help Devices; D012798:Sialorrhea / Q000188:drug therapy* / Q000209:etiology*; D016896:Treatment Outcome
chemical_list: D018726:Anti-Dyskinesia Agents; D018727:Muscarinic Antagonists; D012601:Scopolamine; D001905:Botulinum Toxins