Ultrasound-guided submandibular gland injection of botulinum toxin for hypersalivation in cerebral palsy.

Hypersalivation associated with cerebral palsy may be treated with injection of botulinum toxin A (BTX-A) into the submandibular gland, and the use of ultrasound permits its accurate administration. In our series four patients with cerebral palsy and hypersalivation had bilateral ultrasound-guided injection of BTX-A into the submandibular gland. At 4 weeks there was objective improvement in all patients and subjective improvement in three. The only reported side effect was the temporary inability to retain prosthetic orbital globes in one patient. Ultrasound-guided injection of BTX-A for hypersalivation is effective, and side effects are rare, but they have yet to be fully described.