TY - JOUR
T1 - Onabotulinumtoxin A Treatment of Drooling in Children with Cerebral Palsy: A Prospective, Longitudinal Open-Label Study
AU - Møller, Eigild
AU - Pedersen, Søren Anker
AU - Vinicoff, Pablo Gustavo
AU - Jensen, Allan Bardow
AU - Lykkeaa, Joan
AU - Svendsen, Pia
AU - Bakke, Merete
PY - 2015/6/30
Y1 - 2015/6/30
N2 - 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.
AB - 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.
U2 - 10.3390/toxins7072481
DO - 10.3390/toxins7072481
M3 - Journal article
C2 - 26134257
SN - 2072-6651
VL - 7
SP - 2481
EP - 2493
JO - Toxins
JF - Toxins
IS - 7
ER -