Incobotulinumtoxin A for Sialorrhea in Neurological Disorders: A Real-Life Experience

Abstract

Botulinum toxin type A is one of the most useful treatments of sialorrhea in neurological disorders. Evidence for the use of incobotulinumtoxin A (inco-A) in the treatment of sialorrhea is limited. Thirty-six patients with sialorrhea were treated with infiltrations of inco-A into both parotid glands. The severity of sialorrhea was evaluated by the Drooling Severity Scale (DSS), and the Drooling Frequency Scale (DFS). Patients’ perceptions of clinical benefit were recorded via the Patient Global Impression of Improvement (PGI-I) scale. Following treatment, there was a significant difference in both the DFS and the DSS (p < 0.001). Clinical benefits on the basis of the PGI-I were present in up to 90% of patients.

A systematic review of noninvasive and invasive sialorrhoea management

“…Both botulinum toxins (BoNT) A and B are used for the management of sialorrhoea, and they have shown fewer side effects than anticholinergic medication while also decreasing aspiration pneumonia risk in people with neurological diseases (Faria, Harb, Hilton, Yacobucci, & Pizzuto, ). Studies show that botulinum injections are tolerable and effective in the management of sialorrhoea (Jackson et al, ; Jongerius et al, ; Lagalla, Millevolte, Capecci, Provinciali, & Ceravolo, ; Mancini et al, ; Martínez‐Poles et al, ; Reid, Johnstone, Westbury, Rawicki, & Reddihough, ; Tiigimäe‐Saar, Tamme, Rosenthal, Kadastik‐Eerme, & Taba, ). However, BoNT does have some side effects which relate to trauma at the injection site as well as adverse effects associated with the botulinum toxin, such as dry mouth, thickened bronchial secretion and viscous saliva, and difficulty chewing (Jackson et al, ; Jongerius et al, ; Lagalla et al, ; Mancini et al, ; Martínez‐Poles et al, ; Reid et al, ).…”

“…Studies show that botulinum injections are tolerable and effective in the management of sialorrhoea (Jackson et al, ; Jongerius et al, ; Lagalla, Millevolte, Capecci, Provinciali, & Ceravolo, ; Mancini et al, ; Martínez‐Poles et al, ; Reid, Johnstone, Westbury, Rawicki, & Reddihough, ; Tiigimäe‐Saar, Tamme, Rosenthal, Kadastik‐Eerme, & Taba, ). However, BoNT does have some side effects which relate to trauma at the injection site as well as adverse effects associated with the botulinum toxin, such as dry mouth, thickened bronchial secretion and viscous saliva, and difficulty chewing (Jackson et al, ; Jongerius et al, ; Lagalla et al, ; Mancini et al, ; Martínez‐Poles et al, ; Reid et al, ). Trauma at the injection site can cause adverse effects such as soreness, haematoma, bleeding in the mouth and swollen salivary gland leading to difficulty in swallowing, and it might also cause facial nerve trauma when the injection is performed in the parotid gland (Reddihough et al, ).…”

“…Both botulinum toxins (BoNT) A and B are used for the management of sialorrhoea, and they have shown fewer side effects than anticholinergic medication while also decreasing aspiration pneumonia risk in people with neurological diseases (Faria, Harb, Hilton, Yacobucci, & Pizzuto, 2015). Studies show that botulinum injections are tolerable and effective in the management of sialorrhoea (Jackson et al, 2009;Jongerius et al, 2004;Lagalla, Millevolte, Capecci, Provinciali, & Ceravolo, 2006;Mancini et al, 2003;Martínez-Poles et al, 2018;Reid, Johnstone, Westbury, Rawicki, & Reddihough, 2008;Tiigimäe-Saar, Tamme, Rosenthal, Kadastik-Eerme, & Taba, 2018). However,…”

“…BoNT does have some side effects which relate to trauma at the injection site as well as adverse effects associated with the botulinum toxin, such as dry mouth, thickened bronchial secretion and viscous saliva, and difficulty chewing (Jackson et al, 2009;Jongerius et al, 2004;Lagalla et al, 2006;Mancini et al, 2003;Martínez-Poles et al, 2018;Reid et al, 2008). Trauma at the injection site can cause adverse effects such as soreness, haematoma, bleeding in the mouth and swollen salivary gland leading to difficulty in swallowing, and it might also cause facial nerve trauma when the injection is performed in the parotid gland (Reddihough et al, 2010).…”

Therapie der Sialorrhoe mit Botulinumtoxin

“…1). Die Wirkung für alle Toxine wurde in Fallserien und kontrollierten Untersuchungenteils placebokontrolliertreproduziert [75][76][77][78][79][80][81][82][83].…”