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Radiotherapy reduces sialorrhea in amyotrophic lateral sclerosis.

Abstract
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder. Sialorrhea is a frequent problem in ALS patients with bulbar symptoms, because of progressive weakness of oral, lingual and pharyngeal muscles. This prospective study aimed to investigate the putative effect of palliative single-dose radiotherapy on problematic sialorrhea in patients with ALS. Twenty patients with ALS and problematic drooling were included; 14 were given radiotherapy with a single fraction of 7.5 Grey (Gy). Five patients were treated with botulinum toxin A (BTX-A) injections (20 U) into the parotid glands; two of these were later given radiotherapy. Symptom assessment, clinical examination and measurements of salivary flow (ml/min) were performed before and after treatment (1-2 weeks, 3 months). Salivary secretion was significantly reduced after radiation treatment, with a mean reduction of 60% (1 week) and 51% (2 weeks). Three months post-treatment, 21% reduction of the salivary secretion was observed compared with salivation before treatment. Mean salivary flow was not reduced after BTX-A treatment in five patients. No serious side-effects were observed with either of the two treatment modalities. Single-dose radiotherapy (7.5 Gy) significantly reduces sialorrhea and is an effective and safe palliative treatment in patients with ALS.
AuthorsE Neppelberg, D F Haugen, L Thorsen, O-B Tysnes
JournalEuropean journal of neurology (Eur J Neurol) Vol. 14 Issue 12 Pg. 1373-7 (Dec 2007) ISSN: 1468-1331 [Electronic] England
PMID17941851 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Botulinum Toxins, Type A
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Amyotrophic Lateral Sclerosis (complications, physiopathology)
  • Botulinum Toxins, Type A (administration & dosage)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parotid Gland (physiopathology, radiation effects)
  • Preoperative Care
  • Prospective Studies
  • Radiation Dosage
  • Radiotherapy (methods)
  • Salivary Glands (physiopathology, radiation effects)
  • Sialography
  • Sialorrhea (etiology, physiopathology, radiotherapy)
  • Tomography, X-Ray Computed
  • Treatment Outcome

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