Botulinum toxin B ultrasound-guided injections for sialorrhea in amyotrophic lateral sclerosis and Parkinson's disease.
Sialorrhea is frequent and invalidating in patients with amyotrophic lateral sclerosis (ALS) or Parkinson's disease (PD). Botulinum toxin (BTX) emerged as an alternative to traditional treatments. We evaluated efficacy and tolerability of ultrasound-guided BTX-B injections in parotids and submandibular glands in 18 patients with ALS or PD. At 1 week, both objective (cotton rolls weight) and subjective evaluations (dedicated clinical scales) documented sialorrhea reduction (p<0.01). ALS patients reported shorter benefit duration (p<0.001) and higher prevalence of viscous saliva (seven vs one patients), possibly due to different pattern of autonomic involvement. BTX-B seems efficacious in reducing sialorrhea in ALS and PD but the risk-benefit ratio might differ between these two conditions. This might have implications for clinical practice.
Contarino
Maria Fiorella
MF
Istituto di Neurologia, Università Cattolica del Sacro Cuore, Rome, Italy. m.f.contarino@amc.uva.nl
Pompili
Maurizio
M
Tittoto
Paola
P
Vanacore
Nicola
N
Sabatelli
Mario
M
Cedrone
Augusto
A
Rapaccini
Gian Ludovico
GL
Gasbarrini
Giovanni
G
Tonali
Pietro Attilio
PA
Bentivoglio
Anna Rita
AR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications; D012720:Severity of Illness Index; D012798:Sialorrhea / Q000188:drug therapy* / Q000209:etiology; D013997:Time Factors; D014463:Ultrasonography / Q000379:methods*
D018726:Anti-Dyskinesia Agents; C096323:rimabotulinumtoxinB; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A