Onabotulinumtoxin A Treatment of Drooling in Children with Cerebral Palsy: A Prospective, Longitudinal Open-Label Study

Toxins

Eigild Møller²  Søren Anker Pedersen¹  Pablo Gustavo Vinicoff¹  Allan Bardow²  Joan Lykkeaa²  Pia Svendsen³  Merete Bakke² 

[1] Departments of Pediatrics and Radiology, Hvidovre University Hospital, Hvidovre DK-2650, Denmark; E-Mails:;Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen DK-2200, Denmark; E-Mails:;Gerbrandskolen, Copenhagen Municipal Dental Service, Copenhagen DK-2300, Denmark; E-Mail:

关键词: drooling;    botulinum toxin;    cerebral paresis;    salivary flow;    children;   

DOI  :  10.3390/toxins7072481

来源: mdpi

【 摘 要 】

The aim of this prospective open-label study was to treat disabling drooling in children with cerebral palsy (CP) with onabotulinumtoxin A (A/Ona, Botox^®) into submandibular and parotid glands and find the lowest effective dosage and least invasive method. A/Ona was injected in 14 children, Mean age 9 years, SD 3 years, under ultrasonic guidance in six successive Series, with at least six months between injections. Doses and gland involvement increased from Series A to F (units (U) per submandibular/parotid gland: A, 10/0; B, 15/0; C, 20/0; D, 20/20; E, 30/20; and F, 30/30). The effect was assessed 2, 4, 8, 12, and 20 weeks after A/Ona (drooling problems (VAS), impact (0–7), treatment effect (0–5), unstimulated whole saliva (UWS) flow and composition)) and analyzed by two-way ANOVA. The effect was unchanged–moderate in A to moderate–marked in F. Changes in all parameters were significant in E and F, but with swallowing problems ≤5 weeks in 3 of 28 treatments. F had largest VAS and UWS reduction (64% and 49%). We recommend: Start with dose D A/Ona (both submandibular and parotid glands and a total of 80 U) and increase to E and eventually F (total 120 U) without sufficient response.

【 授权许可】

CC BY   
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