title: Volume matters: the influence of different botulinum toxin-A dilutions for sialorrhea in amyotrophic lateral sclerosis.
abstract: BACKGROUND
  We aimed to determine the effect of different botulinum toxin-A (BTX-A) dilutions on the treatment efficacy and side effects for amyotrophic lateral sclerosis (ALS) related sialorrhea.
  
  
  METHODS
  Ten patients were enrolled in the study. BTX-A dilution for Group A was 100 U in 1 ml of saline, whereas the dilution for Group B was 100 U in 2 ml of saline. Both groups received 20 U of BTX-A in each parotid gland, and assessments were made by means of the Drooling Impact Scale, items 1 and 3 of the ALS functional rating scale, and visual analog scales for drooling and swallowing function.
  
  
  RESULTS
  Although both groups exhibited a similar improvement in drooling, Group B had a mild but significant deterioration in bulbar function that was not evident in Group A.
  
  
  CONCLUSIONS
  These results suggest that BTX-A has a safer profile when reconstituted with 1 ml instead of 2 ml of saline.
authors.affiliation: Department of Neurology, University of Athens, Eginition Hospital, Vas. Sophias Avenue 74, 11528 Athens, Greece. granavan@yahoo.com
authors.forename: Evangelos
authors.initials: E
authors.lastname: Anagnostou
authors.forename: Anagnostou
authors.initials: A
authors.lastname: Evangelos
authors.forename: Michael
authors.initials: M
authors.lastname: Rentzos
authors.forename: Rentzos
authors.initials: R
authors.lastname: Michael
authors.forename: Theodoros
authors.initials: T
authors.lastname: Alexakis
authors.forename: Alexakis
authors.initials: A
authors.lastname: Theodoros
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Zouvelou
authors.forename: Zouvelou
authors.initials: Z
authors.lastname: Vasiliki
authors.forename: Thomas
authors.initials: T
authors.lastname: Zambelis
authors.forename: Zambelis
authors.initials: Z
authors.lastname: Thomas
authors.forename: Ioannis
authors.initials: I
authors.lastname: Evdokimidis
authors.forename: Evdokimidis
authors.initials: E
authors.lastname: Ioannis
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications*; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D012798:Sialorrhea / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A