title: Efficacy and duration of botulinum toxin treatment for drooling in 131 children.
abstract: OBJECTIVE
  To address the efficacy of botulinum toxin and the duration of its effect when used on a large scale for the treatment of drooling in children with neurological disorders.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Academic multidisciplinary drooling clinic.
  
  
  METHODS
  A total of 131 children diagnosed as having cerebral palsy or another nonprogressive neurological disorder and who also have moderate to severe drooling.
  
  
  METHODS
  Injection of botulinum toxin to the submandibular glands.
  
  
  METHODS
  Direct observational drooling quotient (DQ) (0-100) and caretaker visual analog scale (VAS) scores (0-100).
  
  
  RESULTS
  A clinically notable response was found in 46.6% of children, reflected in a significant mean reduction in DQ from a baseline of 29 to 15 after 2 months and 19 after 8 months (P < .001). The mean VAS score decreased from 80 at baseline to 53 after 2 months and increased to 66 after 8 months (P < .001). Kaplan-Meier analysis showed that patients who initially responded to treatment experienced relapse after a median of 22 weeks (interquartile range, 20-33 weeks).
  
  
  CONCLUSIONS
  Our study provides further support for botulinum toxin's efficacy for treatment of drooling in approximately half of patients for a median of 22 weeks. Further optimization of patient selection should be an area of attention in future studies.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen 6525EX, the Netherlands. a.scheffer@kno.umcn.nl
authors.forename: Arthur R T
authors.initials: AR
authors.lastname: Scheffer
authors.forename: Corrie
authors.initials: C
authors.lastname: Erasmus
authors.forename: Karen
authors.initials: K
authors.lastname: van Hulst
authors.forename: Jacques
authors.initials: J
authors.lastname: van Limbeek
authors.forename: Peter H
authors.initials: PH
authors.lastname: Jongerius
authors.forename: Frank J A
authors.initials: FJ
authors.lastname: van den Hoogen
mesh_terms: D000293:Adolescent; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000009:adverse effects / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D009465:Neuromuscular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D010147:Pain Measurement; D012798:Sialorrhea / Q000188:drug therapy* / Q000209:etiology; D013363:Submandibular Gland; D055815:Young Adult
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A