Injections of botulinum toxin A into the salivary glands improve sialorrhoea in amyotrophic lateral sclerosis

Giess, Ralf

doi:10.1136/jnnp.69.1.121

Cited by 184 publications

(138 citation statements)

References 10 publications

Supporting

Mentioning

117

Contrasting

Unclassified

Order By: Relevance

“…[21][22][23] There has been no reported side effect in studies involving children other than mild thickening of saliva and transient gland swelling. [11][12][13] A potential adverse effect of parotid-gland injections is damage to the facial nerve although this has not been reported in any study injecting the parotids.…”

Section: Discussionmentioning

confidence: 99%

Parotid and submandibular botulinum toxin A injections for sialorrhoea in children with cerebral palsy

Banerjee

Glasson

O'Flaherty

2006

Develop Med Child Neuro

View full text Add to dashboard Cite

The aim of this study was to determine whether botulinum toxin A (BTX‐A) injected into the parotid and submandibular salivary glands of children aged 6 to 16 years with cerebral palsy (CP) and relative sialorrhoea significantly decreases their drooling and improves their quality of life. Twenty children (10 males, 10 females; mean age 10y 1mo [SD 3y 8mo]; range 6y 1mo‐16y 7mo) with CP, identified as having significant daily drooling (scoring at least 6 on drooling frequency/severity scales) were recruited. BTX‐A (2U/kg; maximum 70U) was injected under sedation, using ultrasound guidance (1.4U/kg and 0.6U/kg divided between parotid and submandibular glands respectively). Nineteen children completed the study: 15 with spastic quadriplegia (Gross Motor Function Classification System [GMFCS] Level V); one with dystonia (GMFCS Level V); one with hemiplegia (GMFCS Level II); and two with a mixed pattern of CP (GMFCS Levels III and V). Drooling was assessed by five methods at baseline, and 4 and 12 weeks after injection. Qualitative assessment of drooling frequency and severity scores showed statistically significant reductions at 4 weeks (p≤0.001) and 12 weeks (p=0.006). Qualitative assessment of quality of life scores (rated by parents and teachers separately) also significantly improved (p≤0.001 and P=0.023 respectively). Quantitative assessments showed that the number of bibs/scarves changed per day was significantly reduced at 4 weeks (p≤0.001). There was no side effect from the injections themselves; 89% of parents and children wished for further intrasalivary BTX‐A injections in the future. We conclude that percutaneous intrasalivary BTX‐A injections into the parotid and submandibular salivary glands can reduce drooling in children with CP and relative sialorrhoea, leading to an improvement in their quality of life.

show abstract

Section: Discussionmentioning

confidence: 99%

Parotid and submandibular botulinum toxin A injections for sialorrhoea in children with cerebral palsy

Banerjee

Glasson

O'Flaherty

2006

Develop Med Child Neuro

View full text Add to dashboard Cite

show abstract

“…Se debe tener en cuenta una gran cantidad de síntomas en el manejo de los pacientes con ELA; en el caso de la sialorrea, son de utilidad los antidepresivos tricíclicos, las gotas de atropina y, en caso de refractariedad, la toxina botulínica (61). En el paciente con afectación pseudobulbar, el dextrometorfano combinado con quinidina (62); los Figura 1.…”

Section: Tratamientounclassified

Esclerosis lateral amiotrófica: actualización

Zapata-Zapata

Franco-Dáger

Solano

et al. 2016

iatreia

View full text Add to dashboard Cite

RESUMENLa esclerosis lateral amiotrófica es una enfermedad neurodegenerativa que tiene consecuencias devastadoras para el paciente y su familia. Aún no existe claridad sobre su etiología, cerca del 10 % de los pacientes tienen patrón hereditario. La prevalencia mundial varía entre 2 y 11 casos por 100.000 habitantes; el rango de edad de presentación es de 58 a 63 años para los casos esporádicos, y de 47 a 52 años para los familiares, con una ligera predilección por el sexo masculino. Las manifestaciones clínicas incluyen signos de daño de las neuronas motoras superior e inferior tanto en las extremidades como en la musculatura bulbar, y en algunos pacientes hay deterioro cognitivo frontotemporal. El diagnóstico continúa siendo fundamentalmente clínico, apoyado por estudios neurofisiológicos; de estos, la electromiografía de aguja ha sido el más útil para el diagnóstico temprano. No existe tratamiento curativo y solo un medicamento, el riluzol, ha demostrado efectividad para retrasar el uso de ventilación mecánica y prolongar levemente la supervivencia. Por tanto, el tratamiento de estos pacientes se basa en medidas de soporte, especialmente en los aspectos de nutrición y ventilación, además de controlar los síntomas motores y no motores de la enfermedad.

show abstract

“…Botulinum toxin has turned out to be a simple and highly effective treatment option for pathological lacrimation and also in gustatory sweating [38]. Sialorrhea associated with amyotrophic lateral sclerosis, has been successfully treated with botulinum toxin in selected patients [39]. It is seen that anatomically guided injection of botulinum toxin B into the parotid and submandibular glands appears to improve sialorrhea effectively without compromising dysphagia in patients with Parkinson's disease [40].…”

Section: Focal Hyperhydrosismentioning

confidence: 99%

Therapeutic Application of Botulinum Toxin in Clinical Practice

Dash¹,

Araf²

2009

TOGMJ

View full text Add to dashboard Cite

Botulinum toxin, one of the most potent toxins known, is produced by Clostridium botulinum. It causes a temporary paralysis of muscles by inhibiting vesicular release of acetylcholine in neuromuscular junction and synaptic transmission at cholinergic nerve terminals and causes a temporary paralysis of muscles. Since the approval of botulinum toxin A by FDA for strabismus and blepharospasm in 1989 and botulinum toxin B for cervical dystonia in 2000, its therapeutic uses are expanding. To date, both the serotypes A and B have been used therapeutically. These include various dystonic movement disorders, lacrimal hypersecretion, hyperhydrosis, overactive bladder syndromes both neurogenic and idiopathic, prostatic hyperplasia, various gastrointestinal disorders, headache syndromes like migraine and various spastic disorders. Botulinum toxin does not correct the underlying pathology but only produces clinically symptomatic improvement. The duration of improvement and the percentage of improvement vary between different studies due to differences in doses used; different techniques used for injections and also the dilutions. Still more trials are required to explore newer indications of its use, to find out the exact effective doses, dilutions and techniques, so as to have a prolonged clinical improvement. Though it has a good safety profile, complications are related to chemodenervation of adjacent muscles and injection techniques. This article provides an update on different uses of botulinum toxin in medicine.

show abstract

Injections of botulinum toxin A into the salivary glands improve sialorrhoea in amyotrophic lateral sclerosis

Cited by 184 publications

References 10 publications

Parotid and submandibular botulinum toxin A injections for sialorrhoea in children with cerebral palsy

Parotid and submandibular botulinum toxin A injections for sialorrhoea in children with cerebral palsy

Esclerosis lateral amiotrófica: actualización

Therapeutic Application of Botulinum Toxin in Clinical Practice

Contact Info

Product

Resources

About