BOTULINUM TOXIN TYPE A FOR CONTROL OF DROOLING IN ASIAN PATIENTS WITH CEREBRAL PALSY

Abstract

Drooling is a significant problem in 10 to 37% of patients with cerebral palsy.1 Excessive drooling creates major hygienic and psychosocial problems. Current medical management is unsatisfactory.1–3 Botulinum toxin type A (BoNT-A) has increasingly been used to treat drooling in neurologic disorders. 4–7 However, the optimal technique, starting dose, expected duration of effect, and relationship to certain patient characteristics remain to be clarified. The purpose of our study was to evaluate the effect of BoNT-A injection into the contralateral parotid and submandibular glands to control drooling in children with cerebral palsy, and to determine the associated side effects of this treatment. ### Methods. The protocol was approved by our institutional review board. Thirteen patients with cerebral palsy with severe drooling were recruited. Three methods of drooling measurement were adapted: Drooling Severity and Frequency Scale,2 saliva weight, and drooling quotient.3 Patients were randomly assigned to either an experimental or a control group. The experimental group patients received two units of Botox (Allergan)/kg body weight into one parotid and the contralateral submandibular gland under ultrasound guidance (GE 700, GE Company). In the control group, 1.50 mL saline was similarly injected. SAS software (version 8.02; SAS Institute Inc., …