Abstract | BACKGROUND: OBJECTIVES: To evaluate the efficacy and safety of BTX type B in the treatment of sialorrhea in patients with bulbar-onset ALS. METHODS: Open-label prospective study of BTX type B injections in parotids (1000 U) and submandibular (250 U) glands using anatomic landmarks. Primary outcome was rate of responders (improvement > 50% on visual analogue scales (VAS) of severity and disability of sialorrhea) 1 month post-treatment. Other outcomes included subjective ( drooling and quality of daily living questionnaires) and objective (cotton roll weights and number of paper handkerchiefs used) evaluations. Safety evaluations included questionnaires regarding brain stem symptoms. RESULTS: Sixteen ALS patients were included. At 1 month the rate of responders was 75% with a mean reduction of 70% in severity and disabling VASs. Fifteen patients (94 %) reported some benefit with drooling reduction. In objective measurements there was a reduction over 60 % in saliva production and in the number of handkerchiefs used. Onset of effect occurred within 3 days. Most patients reported better quality of living. The most frequent side-effects were viscous saliva, local pain, chewing weakness and respiratory infection. There were no changes in blood pressure or cardiac rate. At 3 months, there was still a positive effect in all outcomes. All patients except one manifested their willingness to repeat treatment. CONCLUSIONS: Anatomic guided BTX type B injections seem effective and safe to treat sialorrhea in bulbar-onset ALS.
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Authors | João Costa, Maria Luz Rocha, Joaquim Ferreira, Teresinha Evangelista, Miguel Coelho, Mamede de Carvalho |
Journal | Journal of neurology
(J Neurol)
Vol. 255
Issue 4
Pg. 545-50
(Apr 2008)
ISSN: 0340-5354 [Print] Germany |
PMID | 18283399
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Neuromuscular Agents
- Parasympatholytics
- rimabotulinumtoxinB
- Botulinum Toxins
- Botulinum Toxins, Type A
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Topics |
- Aged
- Amyotrophic Lateral Sclerosis
(complications, drug therapy, physiopathology)
- Botulinum Toxins
(administration & dosage, adverse effects)
- Botulinum Toxins, Type A
- Humans
- Infant
- Male
- Mastication
(drug effects, physiology)
- Middle Aged
- Neuromuscular Agents
(administration & dosage, adverse effects)
- Pain
(chemically induced, physiopathology)
- Parasympathetic Nervous System
(drug effects, immunology, physiopathology)
- Parasympatholytics
(administration & dosage, adverse effects)
- Patient Satisfaction
- Pilot Projects
- Prospective Studies
- Quality of Life
- Salivary Glands
(drug effects, innervation, physiopathology)
- Sialorrhea
(drug therapy, etiology, physiopathology)
- Treatment Outcome
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