title: The use of botulinum toxin in the treatment of sialorrhea in parkinsonian disorders.
abstract: Drooling is a common symptom in parkinsonian disorders. Our aim was to assess the safety and effect of botulinum toxin when applied to parotid glands without ultrasound guidance for sialorrhea in parkinsonian disorders in a retrospective study with a long-term follow-up. We evaluated 53 patients (64.2% male and 35.8% female) with a mean age of 70.18 ± 9.25 years who were treated in our centre between 2007 and 2013. We analysed the mean dose, latency, effect duration, response and adverse effects of treating sialorrhea by injecting botulinum toxin type A (Botox) into the parotid glands without ultrasound guidance. A total of 41 patients with Parkinson's disease, 6 with progressive supranuclear palsy, 4 with multiple system atrophy and 2 with corticobasal degeneration were included. The mean duration of the disease at onset was 10.51 ± 6.81 years and the mean sialorrhea duration was 1.99 ± 1.55 years. The initial dose used for each parotid gland was 14.53 ± 3.95 units of Botox, with a mean dose of 22.17 ± 8.76 units. There was an improvement after treatment in 65.22% of patients with an average score of 6.85 ± 1.58 points on a scale from 0 to 10. The duration of the treatment effect was 4.38 ± 2.11 months, with a latency period of 10.06 ± 9.63 days. Adverse effects were mild and infrequent. Botulinum toxin is a safe and effective therapy for the treatment of sialorrhea in parkinsonian disorders and there is no requirement for ultrasound guidance. It has a rapid onset and lasting effect without requiring a high dosage.
authors.affiliation: Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Avda. Manuel Siurot s/n, 41013, Seville, Spain.
authors.forename: María T
authors.initials: MT
authors.lastname: Gómez-Caravaca
authors.forename: María T
authors.initials: MT
authors.lastname: Cáceres-Redondo
authors.forename: Ismael
authors.initials: I
authors.lastname: Huertas-Fernández
authors.forename: Laura
authors.initials: L
authors.lastname: Vargas-González
authors.forename: Fátima
authors.initials: F
authors.lastname: Carrillo
authors.forename: Manuel
authors.initials: M
authors.lastname: Carballo
authors.forename: Pablo
authors.initials: P
authors.lastname: Mir
mesh_terms: D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020734:Parkinsonian Disorders / Q000188:drug therapy / Q000503:physiopathology*; D010306:Parotid Gland / Q000187:drug effects*; D018373:Peripheral Nervous System Agents / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D012798:Sialorrhea / Q000188:drug therapy* / Q000503:physiopathology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018373:Peripheral Nervous System Agents; D019274:Botulinum Toxins, Type A