Repeated treatments of drooling with botulinum toxin B in neurology
| Autor: | Merete Bakke, Allan Bardow, Eigild Møller, Kristian Winge, Joan Lykkeaa, O. Holm, B. Belhage, D. Daugaard |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Saliva medicine.medical_specialty Neurology Adolescent Submandibular Gland Drooling Young Adult Saliva collection Increased total protein medicine Humans Parotid Gland Botulinum Toxins Type A Botulinum toxin type B Aged Aged 80 and over Sialorrhea General Medicine Middle Aged Dry mouth Botulinum toxin Neuromuscular Agents Anesthesia Female Neurology (clinical) medicine.symptom Psychology medicine.drug |
| Zdroj: | Acta Neurologica Scandinavica. 131:51-57 |
| ISSN: | 0001-6314 |
| DOI: | 10.1111/ane.12309 |
| Popis: | Moller E, Daugaard D, Holm O, Winge K, Bardow A, Lykkeaa J,Belhage B, Bakke M. Repeated treatments of drooling with botulinumtoxin B in neurology.Acta Neurol Scand 2015: 131: 51–57.© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.Objectives – To investigate efficacy, saliva flow, and composition inrepeated BoNT-B treatments of drooling. Materials and methods –Seventeen neurological patients (median 66 years), referred fortreatment of drooling participated in this observational study. Mediantotal doses of 4000 units botulinum toxin type B (BoNT-B,Neurobloc ) were injected with at least 3 months intervals intoparotid and submandibular glands using ultrasound guidance.Measures of drooling and saliva collection for analysis were obtainedbefore treatment, and 6, 12, and eventually 18 weeks after. Results –Number of treatment series in each patient was 1–7. Compared tobaseline, saliva flow rate and drooling were reduced 30–70% 6 weeksafter treatment in the first series, while sodium, chloride, and totalprotein increased 20–80% (t-tests; P < 0.05). After 12 weeks, droolingwas still significantly reduced, saliva flow tended to be, and salivacomposition was back to baseline. Frequent side effects were viscoussaliva and dry mouth. Due to fading effect in eight patients,individual decisions were taken to change from BoNT-B to BoNT-A.Similarly, the outcome was significantly reduced over time in sixpatients completing five subsequent BoNT-B treatment series(ANOVA; P < 0.05). Conclusion – In the first series, BoNT-Btreatment resulted in marked reduction of drooling and saliva flowrate with some relapse after 12 weeks. The viscous saliva was ascribedto increased total protein content and compensatory mechanismsrelated to s-adrenergic receptor-specific actions. With patients needinglong-term treatment, it should be noted that the efficacy of repeatedBoNT-B may fade with time. |
| Databáze: | OpenAIRE |
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