title: Management of drooling in children with cerebral palsy: A French survey.
abstract: OBJECTIVE
  To characterise children with cerebral palsy (CP) and pathological drooling in France, and to describe care pathways, assessment and treatment.
  
  
  METHODS
  A transversal, observational, descriptive survey of the practices and opinions of 400 health professionals potentially involved in the care of children with CP, was carried out nationally across France in 2013.
  
  
  RESULTS
  The response rate was 36%. Seventy-five questionnaires were returned and analysed (52%). A small proportion of children were specifically treated for drooling (<25%). Assessments were carried out in 75% of cases and 91% of professionals prescribed treatments. Use of assessment tools varied widely. The most common treatment was oro-facial rehabilitation (95% of professionals), followed by anticholinergic drugs (Scopolamine(®)) (94%) botulinum toxin injections (BT) (66%) and surgery (34%). Scopolamine was considered to be less effective than BT and to have more side effects.
  
  
  CONCLUSIONS
  The rate of pathological drooling in children with CP is likely underestimated and under treated in France. There is a lack of knowledge regarding assessment tools. Aside from rehabilitation, current practice is to prescribe medication as the first-line treatment, however professionals consider that BT is more effective and has less side effects.
authors.affiliation: Centre Médico-Chirurgical de Réadaptation des Massues Croix-Rouge française, 69322 Lyon Cedex 05, France. Electronic address: chaleat-valayer.e@cmcr-massues.com.
authors.forename: E
authors.initials: E
authors.lastname: Chaléat-Valayer
authors.affiliation: Centre Hospitalier Universitaire de Nîmes, 30029, France. Electronic address: melanie.porte@chu-nimes.fr.
authors.forename: M
authors.initials: M
authors.lastname: Porte
authors.affiliation: Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon F-69003, France. Electronic address: karine.poyau@chu-lyon.fr.
authors.forename: K
authors.initials: K
authors.lastname: Buchet-Poyau
authors.affiliation: Centre Médico-Chirurgical de Réadaptation des Massues Croix-Rouge française, 69322 Lyon Cedex 05, France. Electronic address: f.roumenoff@cmcr-massues.com.
authors.forename: F
authors.initials: F
authors.lastname: Roumenoff-Turcant
authors.affiliation: Coordination SSR Pédiatrique Hôpital Nord, Saint Etienne 42055, France. Electronic address: m.charlotte.danjou@chu-st-etienne.fr.
authors.forename: M C
authors.initials: MC
authors.lastname: D'Anjou
authors.affiliation: Service de Neurologie Pédiatrique, CHU Timone Enfants, 13385 Marseille, France. Electronic address: christophe.boulay@ap-hm.fr.
authors.forename: C
authors.initials: C
authors.lastname: Boulay
authors.affiliation: Centre Médico-Chirurgical de Réadaptation des Massues Croix-Rouge française, 69322 Lyon Cedex 05, France. Electronic address: bernard-mpr@cmcr-massues.com.
authors.forename: J C
authors.initials: JC
authors.lastname: Bernard
authors.affiliation: Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon F-69003, France; Universite de Lyon, EA 7425 Health Services and Performance Research (HESPER), Lyon F-69008, France. Electronic address: sandrine.touzet@chu-lyon.fr.
authors.forename: S
authors.initials: S
authors.lastname: Touzet
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002547:Cerebral Palsy / Q000150:complications* / Q000188:drug therapy / Q000628:therapy; D002648:Child; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D005260:Female; D005602:France; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D012798:Sialorrhea / Q000150:complications* / Q000188:drug therapy / Q000534:rehabilitation / Q000628:therapy*; D011795:Surveys and Questionnaires
chemical_list: D018680:Cholinergic Antagonists; D019274:Botulinum Toxins, Type A
keywords: Botulinum toxin; Cerebral palsy; Child; Drooling; Observational study; Treatment