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Botulism Toxin Benefit Seen for Drooling in Children

Nearly half of patients with nonprogressive neurological disorders have response at two months

WEDNESDAY, Sept. 22 (HealthDay News) -- Botulinum toxin can help reduce drooling in some children with neurological disorders, according to research published in the September issue of the Archives of Otolaryngology -- Head & Neck Surgery.

Arthur R.T. Scheffer, M.D., of the Radboud University Medical Center in Nijmegen, Netherlands, and colleagues analyzed data from 131 children with cerebral palsy or other nonprogressive neurological disorders who had moderate to severe drooling. They underwent injection of a dose of botulinum toxin type A into the submandibular glands.

The researchers found that 46.6 percent of the subjects had a clinically notable response at two months, based on reduction in direct observational drooling quotient. Mean caretaker visual analog scale score fell from 80.4 at baseline to 53.9 after two months and 65.7 after eight months. The injections were typically well tolerated. Those who responded initially to treatment experienced relapse after a median of 22 weeks.

"Although the observational nature of our study makes it difficult to make definitive statements about the magnitude of botulinum toxin's effect, our results provide further support for the clinical efficacy of botulinum toxin for drooling in patients with nonprogressive neurological disease. Furthermore, they indicate that most patients who initially respond well to injection can expect an effect to last between 19 and 33 weeks. Although the 46.6 percent success rate might appear low, its safety and efficacy make botulinum toxin a useful first-line invasive treatment if conservative measures have failed," the authors conclude.

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