2006, Number 2
Plasticidad y Restauración Neurológica 2006; 5 (2)
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ABSTRACTIntroduction: Sialorrhoea is a disabling problem in many patients affected by neurological disorders. Anticholinergic drugs often produce side effects in these patients. Botulinum toxin A (TBA) blocks liberation of acetylcholine in motor and autonomic nerve terminals. Materials and methods: We report preliminary data about 8 patients with Parkinson’s disease (PD), and 4 patients with sclerosis lateral amyotrophic (ELA). All of them underwent treatment with TBA in both parotid glands to treat sialorrhoea, and were prospectively evaluated. Severity and Frequency Sialorrhoea Scale was used pre-treatment and at 4 weeks (1 month), 12 weeks (3 Months). TBA was administered in two points in each parotid gland, and one point in submaxillary gland; only in 2 patients of PD and 1 of ELA required new injection at 2 weeks only in parotid gland, with a dose ranging between 75 Us and 100 units in each point (1.5 Us by kg). Results: Three females and five males, with a men age of 63.6 ± 7 years are reported. Four patients with PD (4 males), and 4 patients (2 males and 2 females) to ELA. Sialorrhoea pre-treatment severity score was 5 in 5 patients; while pre-treatment frequency score was 4 (continuous sialorrhoea all the days) in 3 patients. Four weeks after TBA injection, six patients scored lowered 2 in severity and 2 only 1. Three patient with ELA with mild sialorrhoea (score 3) pre-treatment, after 4 weeks of treatment dismissed to score 2 in one patients sialorrhoea disappear. No side effects were observed after TBA injections at 4-12 weeks follow-up. Conclusions: Trans-dermic injection of TBA is safe and effective technique to treat sialorrhoea in neurological diseases when used by neurologists with experience, without side effects.