Successful treatment of drooling in children with neurological disorders with botulinum toxin A or B

Neuropediatrics. 2008 Aug;39(4):200-4. doi: 10.1055/s-0028-1112115. Epub 2009 Jan 22.

Abstract

Drooling is a common and severe problem in children with neurological disorders and is caused by a disturbed coordination of orofacial and palatolingual muscles. Botulinum toxin could be a successful option to reduce excessive sialorrhea in children with neurological disorders. In 30 children with cerebral palsy or neurodegenerative disorder we injected under ultrasound guidance either botulinum toxin A or botulinum toxin B into the parotid and submandibular glands on both sides. All injections were well tolerated without general anaesthesia. Drooling severity at baseline and reduction of sialorrhea during treatment was measured using a parent's questionnaire and rated using the Teachers Drooling Scale (TDS). Reduction of sialorrhea was achieved two weeks after injection, with a positive effect lasting about three to four months in most children. 83% showed a good response to botulinum toxin after first injection, but only in 50% treatment was continued. We found no significant differences between botulinum toxin A or B. Side effects were observed in 5 children with viscous saliva and in one child a unilateral parotitis was observed. Treatment of drooling with botulinum toxin into the salivary glands is a safe and easy therapeutic option for children with neurological disorders to improve life quality.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Anti-Dyskinesia Agents / therapeutic use*
  • Botulinum Toxins / classification
  • Botulinum Toxins / therapeutic use*
  • Botulinum Toxins, Type A / therapeutic use
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Nervous System Diseases / complications
  • Parotid Gland / drug effects
  • Retrospective Studies
  • Sialorrhea / drug therapy*
  • Sialorrhea / etiology
  • Sialorrhea / pathology
  • Submandibular Gland / drug effects
  • Ultrasonography / methods

Substances

  • Anti-Dyskinesia Agents
  • rimabotulinumtoxinB
  • Botulinum Toxins
  • Botulinum Toxins, Type A