Clinical efficacy of the application of botulinum toxin type A in the submandibular glands for the treatment of severe sialorrhea in pediatric patients with cerebral palsy
Keywords:
Cerebral palsy,, drooling,, botulinum toxin type AAbstract
Introduction: Prevalence of drooling in children with cerebral palsy is 58%. Only 33% is
profuse. Drooling is extremely uncomfortable for the patient and his care providers as it im-
pairs life quality all around the family environment. The objective was to evaluate the clinical
effectiveness of type A botulinum toxin in the treatment of drooling. Patients and methods:
This is a double blind, controlled clinical trial in pediatric patients aged 4-16 years, who have
cerebral palsy and profuse or severe drooling. Two groups were compared: A (control, type-A
500 U botulinum toxin) and B (experimental, 0.9% sodium chloride). Scales of intensity and
frequency of drooling and functional independence (WeeFIM) were applied at the beginning,
four weeks later and at the end of the treatment (week eight). Results: During a period between
January and August of 2012, 21 patients were included, 13 boys (62%) and 8 girls (38%), with
age averaging 7.0 (4-16 years). Dose of Type-A botulinum toxin in each submaxillar gland was
15-25 U (mean dose of 21 U/gland). The statistical analysis was made by U Mann Whitney
test, the scales of intensity and frequency of drooling and WeeFIM had a p = 0.005 at eight
weeks, which is statistically significant. Conclusion: Type-A botulinum toxin is useful and safe
for the treatment of profuse drooling in pediatric patients with cerebral palsy.
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