title: Successful treatment of drooling in children with neurological disorders with botulinum toxin A or B.
abstract: Drooling is a common and severe problem in children with neurological disorders and is caused by a disturbed coordination of orofacial and palatolingual muscles. Botulinum toxin could be a successful option to reduce excessive sialorrhea in children with neurological disorders. In 30 children with cerebral palsy or neurodegenerative disorder we injected under ultrasound guidance either botulinum toxin A or botulinum toxin B into the parotid and submandibular glands on both sides. All injections were well tolerated without general anaesthesia. Drooling severity at baseline and reduction of sialorrhea during treatment was measured using a parent's questionnaire and rated using the Teachers Drooling Scale (TDS). Reduction of sialorrhea was achieved two weeks after injection, with a positive effect lasting about three to four months in most children. 83% showed a good response to botulinum toxin after first injection, but only in 50% treatment was continued. We found no significant differences between botulinum toxin A or B. Side effects were observed in 5 children with viscous saliva and in one child a unilateral parotitis was observed. Treatment of drooling with botulinum toxin into the salivary glands is a safe and easy therapeutic option for children with neurological disorders to improve life quality.
authors.affiliation: Department of Pediatric Neurology, Klinikum Kassel, Kassel, Germany. wilken@klinikum-kassel.de
authors.forename: B
authors.initials: B
authors.lastname: Wilken
authors.forename: B
authors.initials: B
authors.lastname: Aslami
authors.forename: H
authors.initials: H
authors.lastname: Backes
mesh_terms: D000293:Adolescent; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000145:classification / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009422:Nervous System Diseases / Q000150:complications; D010306:Parotid Gland / Q000187:drug effects; D012189:Retrospective Studies; D012798:Sialorrhea / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D013363:Submandibular Gland / Q000187:drug effects; D014463:Ultrasonography / Q000379:methods
chemical_list: D018726:Anti-Dyskinesia Agents; C096323:rimabotulinumtoxinB; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A