Injections relieve drooling in CP

Botulinum toxin injections may temporarily relieve drooling in children with certain neurological conditions, a new European study has found.

Depending on its severity, drooling can lead to stigmatisation and social neglect, numerous daily clothing changes, skin irritation around the mouth, aspiration pneumonia and dehydration, Dr Arthur Scheffer of Radboud University Medical Center in Nijmegen, the Netherlands, and colleagues noted.

In the study, Scheffer's team gave botulinum toxin injections to 131 children, average age 10.9 years, with cerebral palsy or other non-progressive neurological conditions, as well as moderate to severe drooling. The injections were confined to the submandibular glands, which are responsible for 70% of saliva production while a person is resting.

Two months after the injections, the average drooling quotient had fallen to 15.5 (on a scale of zero to 100) from 28.8 at the start of the study. And, the study authors noted, 61 patients achieved a 50% reduction in drooling.

The study

At the eight-month follow-up, the average drooling quotient was 18.7, according to the report in the September issue of the journal Archives of Otolaryngology - Head & Neck Surgery.

The findings "indicate that most patients who initially respond well to injection can expect an effect to last between 19 and 33 weeks. Although the 46.6% success rate might appear low, its safety and efficacy make botulinum toxin a useful first-line invasive treatment if conservative measures have failed," the researchers concluded in the news release from the journal's publisher.

Botulinum toxin injections have been used safely for years, according to the American Academy of Paediatrics. Side effects can include rash, whole-body muscle soreness, difficulty swallowing and weakness in the injected muscles, but they usually go away quickly, the AAP notes.

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