Botulinun toxin A as a treatment to control sialorrhea in children with cerebral palsy
Keywords:
botulinum toxin A, cerebral palsy, quality of life, sialorrhea.Abstract
Objective: the sialorrhea is a disabling symptom in children with Cerebral Palsy. Botulinum toxin A has been suggested as a treatment of sialorrhea because it acts blocking acetylcholine release from independent and motor nerve terminals. Thepurpose is to measure the efficacy of the Botulinum toxin A in the treatment of sialorrhea in order to reduce disability and disagreeable symptom that can adversely affect feeding and socialization of the children with cerebral palsy.
Methods: this is a prospective pseudo experimental study in 36 patients with diagnosis of cerebral palsy. All patients received infiltrations with Botulinum toxin type A: two points of 10 units in parotids, and one point of 15 units in submandibular. They were
applied bilaterally, guide by ultrasound and under general anesthesia. It applied a qualitative scale previous to the application of the toxin, and 15 days 3 months, 6 and 9 months later to the infiltration. That scale measured the behavior of the children, as far as number of used bibs, feeding, intensity and frequency of the sialorrhea. Epi info 2000 3.2.4 was used.
Results: 36 children with diagnosis of cerebral palsy with ages between 13 and 17 years were studied; 18 men and 12 women. All children had significant changes in the number bibs used before and after the application. It was relevant the mother’s perception about diminution of salivation, and progress in the feeding.
Conclusion: this study suggests that Botulinum toxin A concerning the parotids and submandibular glands in patients with Cerebral Palsy can reduce, in a significant way, salivary flow during 36 weeks. There were no significant adverse side-effects and it was remarkable success on patients and families quality of life.
References
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3. Van De Heyning PH, Marquet JF, Creten WL. Drooling in children with cerebral Palsy. Acta otorrinolaringológica Belg 1980;34:691-705.
4. Bachrach SJ, Walter RS, Tzcinski K. Use of glycopirrolato and other anticholinergic medications for sialorrhea in children with cerebral palsy. Clinic Pediatric (Phila) 1998; 37:485-490.
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8. Porta M, Gamba M, Bertacchi G, Vaj P. Treatment of sialorrhoea with ultrasound guided botulinum toxin type A injection in patients with neurological disorders. J Neurol Neurosurg Psychiatry 2001;70:38-40.
9. Hotaling AJ, Madgy DN, Kuhns LR, Filipek L, Belenky WM. Postoperative technetium scanning in patients with submandibular duct diversion. Arch Otolaryngol Head Neck Surg 1992;118:1331-1333.
10. Jongerius PH, Van den Hoogen FJ, Van Limbeek J,Gabreëls FJ, Van Hulst K, Rottevee JJ. Effect of botulinum toxin in the treatment of drooling: a controlled clinical trial. Pediatrics 2004;114:620-627.
11. Benson J, Daugherty KK. Botulinum toxin A in the treatment of sialorrhea. Ann Pharmacother 2007;41:79-85.
12. Black JD, Dolly JO. Interactions of 125Ilabelled botulinum neurotoxin with nerve terminals. II. Autoradiographic evidence for its uptake into motor nerve terminals by acceptor-mediated endocytosis. J Cell Biol 1986;103:535-544.
2. Ekedahl C. Surgical treatment of drooling Acta otorrinolaringologica 1974;77:215-220.
3. Van De Heyning PH, Marquet JF, Creten WL. Drooling in children with cerebral Palsy. Acta otorrinolaringológica Belg 1980;34:691-705.
4. Bachrach SJ, Walter RS, Tzcinski K. Use of glycopirrolato and other anticholinergic medications for sialorrhea in children with cerebral palsy. Clinic Pediatric (Phila) 1998; 37:485-490.
5. Buchara KO. Sialorrhea in amyotrophic laterals aclerosis a hipothesis of a new treatment botulinun toxin A injection of the parotid gland. Med Hipoptheses 1997;48:337-339.
6. Camp-Bruno JA, Winsberg BG, Green Pearson AR, Abrams JP. Efficacy of bentropine therapy for drooing. Dev Med Child Neurol 1989;31:309-319.
7. Jost WH. Treatment of drooling in Parkinson Disease with botulinun toxin A Mov Disord 1999;14:1057.
8. Porta M, Gamba M, Bertacchi G, Vaj P. Treatment of sialorrhoea with ultrasound guided botulinum toxin type A injection in patients with neurological disorders. J Neurol Neurosurg Psychiatry 2001;70:38-40.
9. Hotaling AJ, Madgy DN, Kuhns LR, Filipek L, Belenky WM. Postoperative technetium scanning in patients with submandibular duct diversion. Arch Otolaryngol Head Neck Surg 1992;118:1331-1333.
10. Jongerius PH, Van den Hoogen FJ, Van Limbeek J,Gabreëls FJ, Van Hulst K, Rottevee JJ. Effect of botulinum toxin in the treatment of drooling: a controlled clinical trial. Pediatrics 2004;114:620-627.
11. Benson J, Daugherty KK. Botulinum toxin A in the treatment of sialorrhea. Ann Pharmacother 2007;41:79-85.
12. Black JD, Dolly JO. Interactions of 125Ilabelled botulinum neurotoxin with nerve terminals. II. Autoradiographic evidence for its uptake into motor nerve terminals by acceptor-mediated endocytosis. J Cell Biol 1986;103:535-544.
How to Cite
1.
Valencia Valencia D, Mendoza A. Botulinun toxin A as a treatment to control sialorrhea in children with cerebral palsy. Rev. Colomb. Med. Fis. Rehabil. [Internet]. 2012 Apr. 14 [cited 2024 May 19];21(1):23-31. Available from: https://revistacmfr.org/index.php/rcmfr/article/view/4
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